腹腔镜下右半肝血流阻断的肝右后叶切除术(附16例报告)

Laparoscopic hepatectomy of the right posterior lobe under hemi-hepatic vascular occlusion: with a report of 16 cases

目的:探讨腹腔镜下采用右半肝血流阻断行肝右后叶切除术的可行性。方法:2016年1月至2016年12月为16例肝右后叶肿瘤患者行完全腹腔镜肝右后叶切除术,术中采用血流阻断。结果:16例手术均获成功,无一例中转开腹,手术时间150~290 min,平均(196.2±12.5)min;右半肝阻断时间20~40 min,平均(26.5±1.2)min;术中出血量150~400 ml,平均(255.0±8.3)ml。术后无出血、肝功能衰竭、胆漏、感染、死亡等严重并发症发生。术后住院5~12 d,平均(6.6±0.5)d。结论:在熟练掌握腹腔镜肝切除操作要点的前提下,采用右半肝血流阻断技术行腹腔镜肝右后叶切除术治疗肝肿瘤是安全、可行的。

Objective：To investigate the feasibility of laparoscopic hepatectomy of the right posterior lobe under hemi-hepatic vascular occlusion in patients with hepatic tumor.Methods：Sixteen cases with hepatic tumors located in the right posterior lobe received laparoscopic hepatectomy of the right posterior lobe under hemi-hepatic vascular occlusion from Jan.2016 to Dec.2016.Results：All 16 patients were operated successfully,none was converted to laparotomy.The operative time ranged from 150 to 290 min with the average of （196.2 ± 12.5） min,the right hemi-hepatic vascular occlusion time ranged from 20 to 40 min with the average of （26.5 ± 1.2） min.The blood loss ranged from 150 to 400 ml with the average of （255.0 ± 8.3） ml.No patients were diagnosed with hemorrhage,liver failure,bile leakage,infection,death or other serious complications postoperatively.The hospital stay was 5 to 12 d with the average of （6.6 ± 0.5） d.Conclusions：Under the precondition of mastering the operation of laparoscopic hepatectomy,laparoscopic hepatectomy of the right posterior lobe under hemi-hepatic vascular occlusion is safe and feasible in the treatment of hepatic tumor.