腹腔镜肝切除术的单中心经验

Clinical application of laparoscopy hepatectomy： a single center＇s experience

本文回顾总结了温州医科大学附属第一医院2006年7月至2014年11月完成的97例腹腔镜肝切除术患者的临床资料。其中肝胆管结石46例，原发性肝癌20例，肝良性肿瘤26例，肝脓肿1例，转移性肝癌4例。手术方式包括左半肝切除16例，左肝外叶切除35例，右半肝切除2例，右肝后叶切除1例，肝脏楔形切除42例，左肝外叶联合第Ⅶ段切除1例，其中有4例联合脏器切除。97例患者中，88例成功完成腹腔镜下肝切除术，中转开腹9例。22例出现术后并发症，胆漏9例，腹腔感染7例，胸腔积液3例，腹水、切口感染、肺部感染各1例。无围手术期再次手术或死亡。研究显示，腹腔镜肝切除术是安全可行的，并具有创伤小、恢复快的优势。

The clinical data of 97 patients who underwent laparoscopic hepatectomy from July 2007 to November 2014 in the First Affiliated Hospital of Wenzhou Medical University was collected. Of the 97 patients,46 cases were diagnosed with hepatolithiasis, 20 with primary liver cancer, 26 with benign liver tumor, l with liver abscess, and 4 with metastatic liver cancer. The surgical approaches included laparoseopie left hepatectomy （ n = 16 ）, left lateral lobectomy （ n = 35 ）, right hepatectomy （ n = 2 ） , right posterior lobeetomy （ n = 1 ） , hepatic wedge resection （ n = 42 ） , and left lateral lobectomy with segment Ⅶ resection （ n = 1 ） , and 4 cases underwent muhi-visceral resection. 88 patients underwent laparoseopic hepatectomy and 9 patients were transferred to open hepatectomy. Postopera- tive complications included bile leakage （n = 9 ）, abdominal cavity infection （ n = 7 ） , ascites （ n = 1 ） , wound infection （ n = 1 ） , pleural effusion （ n = 3 ） and pulmonary infection （ n = 1 ）. There was no perioperative death. Taken together, laparoseopic hepatectomy is feasible and efficient for treating liver diseases and it has the advantages of minimal invasion and rapid recovery.