Glisson蒂横断尾背侧入路腹腔镜左半肝切除术

Clinical Study of Glissonian Approach combined Caudal-Dorsal Approach to Midlle Hepatic Veinin Laparoscopic Left Hemihepatectomy

目的探讨Glisson蒂横断尾背侧入路腹腔镜左半肝切除术的安全性和可行性。方法回顾性分析2017年10月至2020年12月完成的29例Glisson蒂横断尾背侧入路腹腔镜左半肝切除术的临床资料。结果男性19例,女性10例,年龄46~70岁,27例为肝脏恶性肿瘤,2例肝内外胆管结石。29例均顺利完成手术,均全程暴露肝中静脉,手术时间在171±41min。术中失血量在135±114ml,无术中大出血、气体栓塞、中转开腹等,术后无出血、二次手术等并发症,仅1例出现胆漏,延迟拔管引流治愈。术后平均住院时间为5天。结论Glisson蒂横断尾背侧入路腹腔镜左半肝切除术是一种安全可行、高效的手术方式。

Objective To investigate the clinical safety and feasibility of Glissonian approach combined caudal-dorsal approach to midlle hepatic vein in laparoscopic left hemihepatectomy.Methods Between October 2017 and December 2019,29 patients underwent laparoscopic left hemihepatectomy with Glissonian approach combined dorsal approach to middle hepatic vein in two centers.The perioperative results were assessed retrospectively.Results There were 19 males and 10 females(age range:46 to 70 years)including 27 cases with hepatic malignancy,2 cases with hepatolithiasis.All surgeries were completed successfully,which exposed fully the middle hepatic vein.The operative time was 171±41 minutes,estimated blood loss was 135±114 ml.There was no massive hemorrhage,gas embolism and convention to open surgeryintraoperatively.There was no severe complications such as postoperativehemorrhage which needreoperation.Only one case with bile leakage was cured by delaying the extubation.The mean postoperative hospital stay was 5 days.Conclusion Glissonian approach combined caudal-dorsal approach to midlle hepatic vein in laparoscopic left hemihepatectomy is safe,feasible and effective.