选择性左肝动脉结扎在腹腔镜肝切除术中的应用

目的:探讨选择性左肝动脉结扎用于腹腔镜肝切除术的可行性。方法:回顾分析2008年10月至2009年7月我院为19例左肝内外胆管结石、血管瘤患者行腹腔镜肝切除术中行选择性左肝动脉结扎的临床资料。结果:19例手术均获成功,术中出血20~200ml,平均80ml,手术时间90~420min,平均240min,术后住院4~9d,平均5.9d,术后病理示无恶变,无肝脏衰竭、出血、胆漏及膈下脓肿等并发症发生。结论:腹腔镜左肝切除术中选择性左肝动脉结扎术能减少术中出血,安全可行。

Application of selective ligation of left hepatic artery in laparoscopic liver resection

Objective:To discuss the feasibility of selective ligation of left hepatic artery in laparoscopic liver resection.Methods:From Oct.2008 to Jul.2009 we carried out 19 cases of selective ligation of left hepatic artery in laparoscopic liver resection for patients with left intrahepatic and extrahepatic bile duct calculus or hemangioma.The clinical data of these cases were retrospectively analyzed.Results:All cases were successfully performed selective ligation of left hepatic artery in laparoscopic liver resection.The mean operative blood loss was 80ml(range 20-200ml),the mean operative time was 240min(range 90-420min),and the mean postoperative hospital stay was 5.9d(range 4-9d).Pathology results showed no canceration in resected liver lobe.There were no serious complications among the patients,such as liver failure,hemorrhage,bile leakage or subphrenic abscess.Conclusions:Selective ligation of left hepatic artery in laparoscopic liver resection is safe and feasible,can reduce operative blood loss.