Glisson鞘外分离法行腹腔镜肝左外叶切除的疗效观察

Effect of extra-Glissonian transaction approach in laparoscopic hepatic left lateral lobectomy

目的观察腹腔镜无肝门阻断、肝内Glisson鞘外分离法肝左外叶切除术的疗效。方法回顾性分析2016年1月—2017年2月行腹腔镜下无肝门阻断、肝内Glisson鞘外分离法肝左外叶切除术和开腹左肝外叶切除术两组患者手术时间、输血率、出血量、术后丙氨酸氨基转移酶(ALT)峰值、术后并发症发生率、经口进食时间、腹腔引流管拔除时间、术后住院天数。结果无肝门阻断、Glisson鞘外分离法行腹腔镜肝左外叶切除术比开腹手术经口进食时间短、腹腔引流管拔除时间早、术后ALT峰值小、术后住院天数短(P<0.05);而两组出血量和输血量、手术时间、术后并发症发生率差异无统计学意义,均手术成功,患者顺利出院。结论腹腔镜下无肝门阻断、Glisson鞘外分离法肝左外叶切除术疗效较佳。

Objective To observe the effects of no blocking hepatic portal and intrahepatic extra-Glissonian transaction approach in laparoscopic hepatic left lateral lobectomy. Methods Patients who underwent laparoscopic hepatic left lateral lobectomy with no blocking hepatic portal and intrahepatic extra-Glissonian transaction approach and who underwent laparotomy from January 2016 to February 2017 were retrospectively analyzed for operation time,blood transfusion rate,blood loss,postoperative alanine aminotran sfease peak,postoperative complication rate,dietary intake time,abdominal drainage tube remove time,and postoperative hospital stay. Results The patients who had laparoscopic hepatic left lateral lobectomy with no blocking hepatic portal and intrahepatic extra-Glissonian transaction approach showed shorter dietary intake time, earlier abdominal drainage tube remove time,smaller postoperative ALT peak value,and shorter postoperative hospital stay than those who underwent laparotomy （P 〈 0 .0 5 ）; no statistical difference in blood loss, blood transfusion rate, operation time, and postoperative complication rate were observed. Conclusion No blocking hepatic portal and intrahepatic extra-Glissonian dissection under laparoscope is an effective approach for laparoscopic hepatic left lateral lobectomy.