腹腔镜解剖性左半肝切除治疗恶性肿瘤的临床应用

Clinical application of laparoscopic anatomical left hemihepatectomy in the treatment of malignant liver tumor

目的探讨腹腔镜解剖性左半肝切除治疗恶性肿瘤的可行性及安全性。方法对我院肝胆外科2012年6月~2015年6月收治的左肝恶性肿瘤患者实施腹腔镜解剖性左半肝切除术。结果 28例患者成功行腹腔镜下解剖性左半肝切除术,3例患者中转开腹,无术后出血及死亡病例。手术时间195~295min,平均215min,术中出血量150~1 120ml,平均320ml,住院时间6~12d,平均7.5d。术后有3例出现胆漏,经腹腔引流3~11d后愈合;4例腹腔积液,经输人血白蛋白营养支持治疗、利尿后治愈。结论腹腔镜解剖性左半肝切除安全、可行,具有微创的优点,适用于左肝恶性肿瘤的治疗。

Objective To explore the feasibility and safety of laparoscopic anatomical left hemihepatectomy in the treat-ment of malignant liver tumors. Methods Patients with malignant liver tumor underwent laparoscopic anatomical left hemi-hepatectomy from Jun 2012 to Jun 2015 were selected . Results The laparoscopic anatomical left hemihepatectomy was suc-cessfully performed in 28 cases, while 3 converted to laparotomy. No bleeding or death occurred after all these operations. The mean surgical time was 215 minutes; the mean blood loss was 320ml,and the mean postoperative hospital day was 7.5 days. Postoperative complications included 3 patients with bile leakage,which recovered after 3~11 days of treatment with draining and 4 patients with seroperitoneum,which recovered after transfusing albumin and diuresis. Conclusion Laparoscopic anatomical left hemihepatectomy is safe and feasible for the treatment of malignant liver tumor , with an advantage of minimally invasive.