腹腔镜肝尾状叶肿瘤切除的临床分析

Totally laparoscopic hepatectomy for hepatic caudate lobe tumors

目的探讨腹腔镜肝尾状叶肿瘤切除的可行性及安全性。方法回顾性分析浙江省金华市中心医院6例腹腔镜肝尾状叶肿瘤切除术患者的临床资料。结果6例患者均在腹腔镜下顺利完成手术。手术方式包括单纯肝尾状叶部分切除4例,左半肝切除联合尾状叶部分切除1例,左肝外叶切除联合尾状叶部分切除1例。手术时间130~240 min,平均190 min。术中失血量60~480 ml,平均185 ml。术后无出血、腹腔感染等并发症,发生胆漏1例,经保守治疗2个月后治愈。术后病理与术前诊断符合,肝血管瘤4例,肝癌2例。肿瘤患者手术切缘均为阴性。术后患者均恢复良好,术后随访4~48个月,未见肿瘤复发。结论在严格掌握手术适应证,熟练腹腔镜肝脏外科技术后,行腹腔镜肝尾状叶肿瘤切除术是安全、可行的。

Objective To investigate the safety and feasibility of laparoscopic resection of hepatic caudate lobe tumor.Methods The clinical data of six patients who underwent laparoscopic hepatic caudate lobe tumor resection in Jinhua Municipal Central Hospital were retrospectively analyzed.Results Laparoscopic procedures were successful in all the 6 patients.Four patients underwent partial caudate lobe resection,1 patient did combined left hemihepatectomy with partial caudate lobe resection,and 1 patient underwent combined left lateral lobectomy.The operation time ranged from 130 to 240 minutes with a mean of 190 minutes.The intraoperative blood loss ranged from 60 to 480 ml with a mean of 185 ml.Postoperative bile leakage occured in 1 case.The primary diseases were hepatic haemangioma(n=4)and hepatocellular carcinoma(n=2),margin negtiveness achieved.The follow-up period was from 4 to 48 months,the patients recovered well and no recurrence was found.Conclusions Laparoscopic resection of hepatic caudate lobe tumor was safe and feasible in appropriately selected patients with skilled laparoscopic techniques.