中国实用外科杂志

中国实用外科杂志

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腹腔镜循肝静脉入路解剖性肝切除术97例疗效分析

成    伟，左    芝，刘    毅，吴一飞，朱斯维，彭    创，沈贤波，尹新民   

  1. 湖南省人民医院肝胆微创外科，湖南长沙 410005
  • 出版日期:2017-05-01 发布日期:2017-04-28

  • Online:2017-05-01 Published:2017-04-28

摘要：

目的    探讨腹腔镜循肝静脉入路解剖性肝切除的临床疗效。方法    回顾性分析2013年1月至2016年12月的湖南省人民医院微创外科97例腹腔镜循肝静脉入路解剖性肝切除术病例资料。结果   97例病人中，Pringle法阻断70例，均为“15+5”模式，最多阻断6次；鞘内阻断60例，鞘外阻断24例。97例病人手术时间为（305.3±156.1）min，术中出血（133.3±170.4）mL，中转开腹手术3例，术后胸腔积液4例，胆漏1例，伤口感染1例，均保守治疗治愈，无再次手术和手术死亡病例。住院时间为（16.1±5.5）d。结论    腹腔镜循肝静脉入路解剖性肝切除在器械、方法、技术保障下可以安全有效施行。

关键词: 腹腔镜, 肝切除, 解剖性肝切除, 循肝静脉入路

Abstract:

Laparoscopic anatomical hepatectomy of hepatic vein approach：A therapeutic analysis of 97 cases        CHENG Wei, ZUO Zhi, LIU Yi, et al. Department of Hepatobiliary Minimally Invasive Surgery, Hunan Provincial People's Hospital, Changsha 410005, China
 Corresponding author：YIN Xin-min, E-mail:13319587618@163.com
Abstract    Objective    To investigate the clinical outcomes on laparoscopic anatomical hepatectomy through hepatic vein approach. Methods    The data of 97 cases of laparoscopic anatomical hepatectomy through hepatic vein approach between January 2013 and December 2016 in Hunan Provincial People's Hospital were reviewed retrospectively. Results    Seventy cases underwent vascular inflow control by Pringle’s maneuver ,in the mode of “15+5”, 6 times at most. Also, 60  and 24 cases subjected to the Glisson intra-and extra-pedicles vascular inflow occlusion respectively. The operative time was (305.3±156.1)min, the blood loss was (133.3±170.4)mL. Three cases conversed to open surgery. Acfter operation,  4 cases showed pleural effusion, 1 case showed bile leaks and 1 case showed wound infection, which resolved on hospital non-operative treatment. No case performed reoperation and no death occurred. The hospital stay was (16.1±5.5) days. Conclusion    Laparoscopic anatomical hepatectomy through hepatic vein approach can be implemented efficiently and effectively with the insurance of instrument, method and surgical manipulation.

Key words: laparoscopy, hepatectomy; , anatomical hepatectomy, hepatic vein approach