关键词: 腹腔镜肝切除术, 出血

Abstract: Risk factors and countermeasures of intraoperative bleeding during laparoscopic hepatectomy        ZHENG Shu-guo*，WANG Bao-lin. *Institute of Hepatobiliary Surgery of PLA, Southwest Hospital, the Army Military Medical University, Chongqing 400038，China
Corresponding author：ZHENG Shu-guo, E-mail: shuguozh@163.com
Abstract    Bleeding is a difficult problem that must be faced in laparoscopic hepatectomy, and it is also an important factor that restricts the popularization of laparoscopic hepatectomy. Moreover, bleeding and blood transfusion increase the risk of postoperative complications and tumor recurrence. The risk factors of hemorrhage during laparoscopic hepatectomy include background of basic liver diseases, tumor size, location and character, surgical approaches and operation skills, intraoperative fluid, and anesthesia management. Prevention of intraoperative bleeding during laparoscopic hepatectomy should be emphasized. Strictly control of the surgical indications, selecting the correct surgical approach and navigation method based on the three-dimensional visualization evaluation and surgical planning, and taking the countermeasures such as delicate surgical operation, hepatic blood flow occlusion and controlling low CVP can significantly reduce the risk of intraoperative bleeding. Proficient endoscopic suture technique and competent assistant cooperation are the ultimate means to control the bleeding during laparoscopic hepatectomy.

Key words: laparoscopy hepatectomy, bleeding