Abstract: Prevention and management of secondary injury during laparoscopic hepatectomy        TAI Sheng. Department of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Abstract    With the development of laparoscopic hepatectomy in China, the surgical indications and surgical resection range of laparoscopic hepatectomy are gradually expanding. For surgeons, the risk of accidents and surgery during operation is also gradually increasing. The secondary injuries in laparoscopic hepatectomy mainly include bile duct injury, intraoperative bleeding, diaphragm injury, gas embolism, and so on. When an accidental injury occurs during the operation, the type of injury should be correctly identified immediately, corresponding treatment strategies should be taken promptly, and the injury should be treated in time to avoid more severe consequences. At the same time, the reasonable use of indocyanine green(ICG) fluorescence staining and real-time ultrasound, and other auxiliary techniques during the operation can reduce the occurrence of intraoperative secondary injury.

Key words: laparoscopic hepatectomy, bile duct injury, intraoperative bleeding, secondary injury, treatment strategies

摘要： 随着腹腔镜肝切除术在国内开展，腹腔镜肝切除术的手术适应证和手术范围在逐渐扩大，外科医生在手术操作过程中的意外和手术风险也逐渐提高。腹腔镜肝切除术中副损伤主要包括胆管损伤、术中出血、膈肌损伤、气体栓塞等。当在术中发生意外损伤时，应立即正确辨别出损伤类型，并迅速采取对应的处理策略，及时处理损伤，避免造成更严重的后果。同时，在术中合理使用吲哚菁绿（ICG）荧光染色及实时超声等辅助技术，可减少术中副损伤的发生。

关键词: 腹腔镜肝切除术, 胆管损伤, 术中出血, 副损伤, 处理策略