经头侧入路腹腔镜解剖性左半肝切除术7例分析

Analysis of 7 cases of laparoscopic anatomical left hemihepatectomy from the head side

目的探讨经头侧入路腹腔镜解剖性左半肝切除术的可行性。方法回顾性分析2014年1月至2016年12月第三军医大学西南医院全军肝胆外科研究所7例行经头侧入路腹腔镜解剖性左半肝切除术病人的临床资料。结果 7例病人中男性3例,女性4例;年龄47~72岁;术前诊断左肝内胆管结石5例,左肝肝细胞癌2例。7例病人均顺利完成手术。手术时间180(160~230)min,术中失血量200(100~350)mL。术后无胆漏、出血等并发症发生,1例病人出现胃排空障碍,予以保守治疗治愈出院。术后住院时间4~26 d。结论经头侧入路进行腹腔镜解剖性左半肝切除安全、可行。

Objective To investigate the feasibility of laparoscopic anatomical left hemihepatectomy from the head side. Methods The clinical data of 7 cases who underwent [aparoscopic anatomical left hemihepateetomy from the head side in Southwest Hospital of the Third Military Medical University between January 2014 and December 2016 were reviewed retrospectively. Results There were 3 male and 4 female patients, aged 47-72 years old. Before operation, 5 cases diagnosed as left hepatolithiasis, and 2 as hepatocellular carcinoma in left lobe. All cases underwent laparoscopic anatomical left hemihepatectomy from the head side successfully. The operation time was 180 （160-230）minutes, estimated blood loss was 200 （100-350）mL. There was no such severe complications such as hemorrhage and biliary fistula. One case had delayed gastric emptying. Postoperative hospital stay was 4-26 days. Conclusion Laparoscopic anatomical left hemibepatectomy from the head side may be safe and feasible to perform.