Abstract: Laparoscopic liver surgery has been widely used in the surgical treatment of various benign and malignant liver diseases. From the perspective of surgery and oncology, it has been proved that it can bring patients dual benefits of minimally invasive and survival. Due to the complexity of liver anatomy and pathology as well as the inherent limitations of laparoscopic surgery, laparoscopic liver surgery is difficult and risky, and the overall development and promotion still face great difficulties and challenges. How to ensure the safety of laparoscopic liver surgery remains a problem that needs to be focused on and urgently solved in the field of hepatic surgery. Strict control of surgical indications, accurate preoperative evaluation and surgical planning are important prerequisites to ensure the safety of laparoscopic liver surgery. Prevention and control of intraoperative bleeding, treatment of important vessels and control of liver resection plane are the three key technical links to ensure the safe implementation of laparoscopic liver surgery. The first two links mainly ensure the safety of surgery, while the third link focuses on the safety of oncology. The three links complement each other and run through the whole process of laparoscopic liver surgery.

Key words: laparoscopy, hepatectomy, safety, technique

摘要： 腹腔镜肝脏手术目前已广泛应用于各种肝脏良恶性疾病的外科治疗，从外科学和肿瘤学的角度，均证实能给病人带来微创和生存双重获益。由于肝脏解剖、病理学复杂性及腔镜手术固有局限性，腹腔镜肝脏手术的难度和风险较大，整体发展和推广仍面临较大困难和挑战，如何保证腹腔镜肝脏手术的安全性仍是目前肝脏外科领域需要重点关注和亟待解决的问题。严格把控手术适应证、精准术前评估与手术规划是保证腹腔镜肝脏手术安全性的重要前提。术中出血防控、重要管道处理及断肝平面掌控是保证腹腔镜肝脏手术安全实施的三个关键技术环节，前两个环节主要保证外科学安全，第三个环节重点保证肿瘤学安全。三个环节相辅相成，贯穿腹腔镜肝脏手术全过程。

关键词: 腹腔镜, 肝切除术, 安全性, 技术