Abstract: Risks and countermeasures during laparoscopic hepatectomy for liver parenchyma dissection        ZHANG Lei. Department of Hepatology，Sun Yat⁃sen Memorial Hospital，Sun Yat⁃sen University，Guangzhou 510120，China
Abstract    With the improvement of instruments and equipment, the further understanding of liver anatomy, and the accumulation of surgical techniques and experience, laparoscopic hepatectomy has been gradually standardized and streamlined, even the basic hospitals are also gradually carried out. However, the process of liver parenchymal detachment in laparoscopic hepatectomy is still full of risks and challenges, mainly reflected in the fact that the plane of liver dissection is difficult to accurately grasp the whole process, the bleeding of liver pedicle and hepatic vein is difficult to avoid, and the bile leakage in postoperative liver wounds is sometimes difficult to be completely prevented. Therefore, in every case of laparoscopic hepatectomy, preoperative evaluation and preparation must be fully done, careful and meticulous operation should be done during the operation, and the occurrence of postoperative complications should be actively prevented, so as to safely complete every laparoscopic hepatectomy.

Key words: laparoscopy hepatectomy, plane of liver resection, bleeding, bile leakage

摘要： 随着器械设备的改进，肝脏解剖认识的进一步深入，手术技术和经验的积累，腹腔镜肝切除术已逐步标准化及流程化，甚至基层医院也在逐步开展。然而，腹腔镜肝切除肝实质离断过程仍然充满风险与挑战，主要体现在断肝平面难以全程精准把握，肝蒂及肝静脉的出血难以避免，术后肝创面的胆漏有时难以完全预防。因此，腹腔镜肝切除的每一个病例都必须充分做好术前的评估与准备，术中均应做到谨慎细致操作，并积极预防术后并发症的发生，方能安全完成每一台腹腔镜肝切除手术。

关键词: 腹腔镜肝切除术, 肝断面, 出血, 胆漏