腹腔镜肝左外叶切除11例报告

Laparoscopic hepatic left lateral lobectomy: report of 11 cases

目的探讨腹腔镜下肝左外叶切除术的可行性。方法直径小于 10cm ,位于肝左外叶的 5例原发性肝癌 ,4例肝海绵状血管瘤 ,2例肝局限性增生结节患者 ,在全气腹状态、气腹结合免气腹或腹腔镜加小切口下 ,采用微波固化、超声刀、钳夹电凝、旋转刮吸和切割缝合器等多种断肝方法行腹腔镜肝切除术。结果腹腔镜肝左外叶切除 11例均获得成功 ,手术时间 1 5～ 6h ,术中出血5 0～ 5 0 0ml。术后恢复顺利 ,住院时间为 5～ 15d。结论直径小于 10cm ,无周围脏器浸润的肝左外叶肿瘤行腹腔镜肝切除术是安全可行的。

Objective To investigate the safety and feasibility of laparoscopic hepatic left lateral lobectomy. Methods Five cases of liver cancer, 4 cases of hepatic hemangioma, and 2 cases with suspected liver tumors were included in this series. Tumors were all located at left lateral lobe, with a diameter less than 10?cm. Tumors were resected by laparoscopy under a combination of pneumoperitoneum and non-pneumoperitoneum, with hand assistance through a mini-incision. Several manoeures were used for the dissection of liver tissue, including microwave coagulation, ultrasonic dissection, tainium clips clamping, rotating suction, endogia ligation. ResultThe procedure was successful in all cases with the operation time ranging from 1.5?h to 6?h, and bleeding was 50?ml to 500?ml. The hospitalization time were from 5?d to 15?d. ConclusionLaparoscopic liver resection is safe and feasible for the left liver lateral lobe tumor when the diameter is less than 10?cm, and not involving surrounding organs.