完全腹腔镜下肝左外叶解剖性切除七例

Laparoscopic anatomical resection of left lateral liver

目的探讨完全腹腔镜下肝脏左外叶解剖性切除手术的方法和适应证。方法在不阻断全肝血流的情况下 ,应用多种器械于完全腹腔镜下进行解剖性肝左外叶切除 7例 (男 3例 ,女4例 ) ,其中原发性肝癌 2例 ,肝脏血管瘤 5例 (2例为多发 )。术前 3例行超声和CT检查 ,4例行超声、CT和MRI检查。结果 7例手术均在完全腹腔镜下顺利完成 ,平均手术时间 2 10min ,平均出血量70 0ml,平均输血量 343ml。术后平均住院 5 7d ,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及在不阻断全肝血流的情况下 ,可安全地进行腹腔镜肝左外叶解剖性切除。

Objective To evaluate the feasibility of and indications for laparoscopic left lateral hepatectomy. Methods The candidates for laparoscopic left lateral lobectomy were 7 cases with liver lesions including 2 cases of primary liver cancer,5 cases of liver hemangioma. Results These patients underwent laparoscopic hepatectomy uneventfully. The operation time averaged at 210 min. The blood loss in operation averaged at 700 ml. The postoperative hospital stay averaged at 5.7 days. No complications occurred. Conclusion Based on these preliminary results, we conclude that laparoscopic anatomical left lateral lobectomy can be carried out safely and effectively by a surgeon with the sufficient expertise of laparoscopy and hepatobiliary surgery.