肝切除术后放置腹腔引流的争议与进展

Controversy and progress of peritoneal drainage after hepatectomy

肝切除后一般通过腹腔引流来及时排出手术部位的渗液和监测术后可能的并发症。随着快速康复外科理念的发展,肝切除术后是否放置引流管及其留置时间存在较大争议。本文结合国内外研究进展,对肝脏切除术后是否放置引流管、临床常用腹腔引流装置、引流管拔除时机及指征、留置引流管可能引起的并发症及预防措施、智能引流装置对引流管理的改善作用等方面进行综述,对上述问题进行再思考,以期提高在精准医学水平上肝切除术后腹腔引流的应用及管理。

After resection,abdominal drainage is generally used to drain the exudate at the surgical site timely and monitor possible postoperative complications.With the development of the concept of enhanced recovery after surgery,there is a great controversy about whether to place drainage tube and its retention time after hepatectomy.Based on the research progress at home and abroad,this article reviews whether to place drainage tubes after hepatectomy,commonly abdominal drainage devices in clinical practice,the timing and indications of drainage tube removal,possible complications and preventive measures caused by indwelling drainage tubes,and the improvement effect of intelligent drainage devices on drainage management.The above issues are reconsidered in order to improve the application and management of abdominal drainage after hepatectomy at the level of precision medicine.