中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (08): 669-670.

• 论著 • 上一篇    下一篇

捆绑式肝局部血流阻断技术在腹腔镜肝切除术中的应用

甄作均，王峰杰   

  1. 佛山市第一人民医院肝胆外科，广东佛山 528000
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-08-01 发布日期:2009-08-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-08-01 Published:2009-08-01

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摘要：

目的 探讨在腹腔镜肝细胞癌切除术中应用捆绑式局部血流阻断技术的可行性和有效性。方法 回顾性分析佛山市第一人民医院肝胆外科2004年3月至2008年1月因肝Ⅱ、Ⅲ段肝细胞癌行腹腔镜肝切除26例的临床资料，其中术中应用Pringle法阻断入肝血流14例（A组），行捆绑式肝局部血流阻断12例（B组），比较两组术中出血量，术后丙氨酸转氨酶（ALT）、总胆红素（TBIL）的变化及中位住院天数。结果 两组术中出血量的差异无统计学意义（P>0.05）；A组病人术后ALT升高的幅度大于B组，B组病人术后ALT的恢复快于A组（P<0.01）。两组术后TBIL的差异无统计学意义（P>0.05）。B组病人中位住院时间短于A组（P<0.01）。结论 捆绑式肝局部血流阻断技术在腹腔镜下是可行的，有效控制局部血流，对肝脏损伤小，特别适用于合并肝硬化病人。

关键词: 腹腔镜, 肝切除术, 局部血流

Abstract:

Application of binding local inflow occlusion in laparoscopic hepatectomy ZHEN Zuo-jun,WANG Feng-jie.Department of Hepatobiliary Surgery ,the First People’s Hospital of Foshan,Foshan 528000,China Corresponding author:ZHEN Zuo-jun, E-mail: docterwfj@sina.com Abstract Objective To evaluate the feasibility and efficacy of binding local inflow occlusion in laparoscopic hepatectomy for hepatocellular carcinoma (HCC). Methods A retrospective comparative study for laparoscopic liver resection for HCC in the segments of Ⅱ and Ⅲ using either the Pringle maneuver (group A,14 cases) or the binding local inflow occlusion method (group B,12 cases) were initiated in Department of Hepatobiliary Surgery of the First People’s Hospital of Foshan between March 2004 and October 2008. The intraoperative blood loss, postoperative alanine aminotransferase (ALT) and total bilirubin (TBIL), the medina hospital stay between the two groups were analyzed. Results No differences in the intraoperative blood loss were found between the two groups(P>0.05). The ALT were significantly elevated in group A when compared with group B, group B patients also had significantly faster recovery of liver function(P<0.01). No differences in TBIL were found between the two groups(P>0.05).The medina hospital stay for group B were significantly shorter than group A(P<0.01). Conclusion Binding local inflow occlusion in laparoscopic hepatectomy was feasible, effectively blocked local inflow and decreased the damage to remnant liver, especially was suit for patients with cirrhosis liver disease.

Key words: laparoscopy , hepatectomy , local inflow