腹腔镜肝癌根治术的难点与争议

Controversies and difficulties of laparoscopic resection of liver cancers

随腹腔镜肝切除经验的积累和设备的改进,腹腔镜肝切除的手术指征与开放手术已基本相同。但由于肝癌肝切除本身就面临手术指征和切除范围等主要问题的争议,加上腹腔镜肝切除固有的较难控制出血、显露困难等问题,使腹腔镜这项技术应用在肝癌根治性切除中存在更多值得磋商的事项。本文就腹腔镜肝切除的手术适应证、切除范围及困难部位的肝切除等问题做一述评,以期对上述问题引起重视,使腹腔镜肝切除在临床应用中更加合理。

With rapidly improvement of surgical instrumentation and accumulation of surgical experience , indications of laparoscopic hepatectomy are basically the same as those of open surgery. However , several problems remain controversial such as surgical indications and the extent of liver resection, therefore laparoscopic hepatectomy is more difficult than other surgery, which required better skills of bleeding control and surgical exposure. This article reviewed the indications of laparoscopic hepatectomy, the extent and the difficulties of the resection, which required more attention, in order to make laparoscopic hepatectomy more reasonable in clinical application.