中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (04): 313-315.

• 论著 • 上一篇    下一篇

腹腔镜肝血管瘤手术43例疗效分析

靳小建，卢榜裕，蔡小勇，陆文奇，黄玉斌，江文枢，黄    飞   

  1. 广西医科大学第一附属医院微创外科中心，广西南宁 530021
  • 出版日期:2011-04-01 发布日期:2011-05-30

  • Online:2011-04-01 Published:2011-05-30

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摘要：

目的    探讨腹腔镜肝血管瘤手术的可行性和疗效。方法    回顾性分析2003年11月至2009年10月广西医科大学第一附属医院微创外科中心进行的43例腹腔镜肝血管瘤手术病例的临床资料。肝门阻断采用自制的肝门阻断器或进行半肝阻断，根据肿瘤的部位和血管的关系进行血管瘤剜除术、肝左外叶切除或部分切除术。使用电刀、超声刀等进行切除。结果    41例成功应用腹腔镜完成手术，2例因大出血中转开腹手术，中转率为4.6%（2/43）。无死亡病例，肿瘤直径为（6.24±2.87）cm，手术时间为（125.27±74.76）min，肝门阻断时间为（11.27±14.11）min。术中出血量为（285.50±425.04）mL, 术中输血（1.22±2.57）单位，术后引流量为（169.61±224.43）mL，术后恢复活动时间为（2.20±0.99）d，术后住院时间为（8.5±3.6）d。总住院时间为（17.5±7.4）d，总住院费用为（11441.6±9668.7）元。术后2例出现并发症，发生率为4.8%，胆漏1例，肝下脓肿1例，均经保守治疗痊愈。结论    选择合适的病例，掌握肝门阻断技术，腹腔镜肝血管瘤手术是安全、可行的。

关键词: 腹腔镜, 肝切除术, 血管瘤

Abstract:

Effective of laparoscopic treatment of hepatic hemangioma        JIN Xiao-jian, LU Bang-yu, CAI Xiao-yong, et al. Department of Minimally Invasive Surgery，the First Affiliated Hospital，Guangxi Medical University，Nanning 530021，China
Corresponding author: LU Bang-yu, E-mail: jj541@sohu.com
Abstract    Objective    To evaluate the feasibility and effective of laparoscopic treatment of hepatic hemangioma．Methods    The clinical data of 43 cases of laparoscopic treatment of hepatic hemangioma from November 2003 to October 2009 in the Department of Minimally Invasive Surgery，the First Affiliated Hospital of Guangxi Medical University were analyzed retrospectively．The portal blood stream was blocked by the home-made laparoscope portal blood blocker or semi-block. Electronic knife and ultrasound knife were used in hemangioma enucleation, hepatic left lateral lobectomy and partial excision. Results    Laparoscopic treatment of hepatic hemangioma was performed in 41 cases successfully．Conversion laparotomy was performed in two out of 43 (4.6%) cases for uncontrolled bleeding. There was no mortality. The tumor diameter was (6.24±2.87)cm. The  operating time was (125.27±74.76) min. The time of block was (11.27±14.11) min. The intraoperative blood loss was (285.5±425.04)mL. The volum of intraoperative blood transfusion was (1.22±2.57)u. The volume of postoperative drainage was (169.61±224.43)mL. The time taken to return to normal activity after operation was (2.20±0.99) days. The length of stay after operation was (8.5±3.6) days. The total length of stay was (17.5±7.4) days. The total outlay was (11441.6±9668.7) Yuan RMB. The postoperative complications were occurred in 2 (4.8%) cases, which were 1 case of bile leakage and 1 case of subhepatic abscess. The 2 cases were recovered after expectant treatment. Conclusion    Laparoscopic treatment of hepatic hemangioma is safe and feasible if suitable patients were selected and hepatic portal blood block technique was mastered by surgeons.

Key words: laparoscope, hepatectomy, hemangioma