完全腹腔镜解剖性左半肝切除3例报告

Laparoscopic anatomical resection of left liver:report of 3 cases

目的 研究如何完成完全腹腔镜下左半肝切除术。方法 2 0 0 2年 7～ 12月 ,在不阻断全肝血流的情况下 ,应用多种器械行完全腹腔镜下解剖性左半肝切除 3例 ,其中原发性肝癌 1例、肝囊肿伴感染 1例、肝门部胆管癌 1例。结果 3例手术均在完全腹腔镜下顺利完成 ,手术时间平均 30 0min ,出血量平均 2 6 7mL。术后平均住院 6 3d ,腹腔引流管放置时间 2～ 4d。未发生胆漏、出血、感染等并发症。结论 在现有的手术器械条件下 ,可安全地进行腹腔镜解剖性左半肝切除。该方法可作为病灶局限于左半肝的病例的首选术式之一。

Objective To study how to manage laparoscopic anatomical left liver resections.Methods Laparoscopic anatomical left liver resections were performed in 3 cases including 1 of primary liver cancer,1 infected liver cyst and 1 hilar carcinoma.Electric-cautery,ultracision and endo-cutter were used for liver transection.The key procedures are anatomical dissection of hepatic vessels followed by clips and transection.Results Fully laparoscopic anatomical left liver resections were accomplished for all the 3 cases.The mean operation time was 300 min.The average blood loss in operation was 267mL.The postoperative hospital stay was 6～8 days.No complication occurred.Conclusion Laparoscopic anatomical left liver resection is a prospective and minimally invasive technique,which can be carried out safely and effectively with decreased postoperative pain and hospital stay time.