腹腔镜肝切除术肝细胞凋亡的研究

目的:探讨腹腔镜和开腹肝左外叶切除手术患者肝细胞的凋亡及其与术后肝功能恢复的关系。方法:2003年9月至2004年7月行腹腔镜肝左外叶切除术24例,其中肝癌17例,肝内胆管结石7例。同期开腹行左外叶切除术28例,其中肝癌19例,肝内胆管结石9例,两组患者均于术中取肝组织检测细胞凋亡。术后肝功能恢复标准依据术后腹水、黄疸、肝性脑病情况分为良好组、轻度组、重度组,并进行比较。结果:腹腔镜组肝细胞凋亡指数与开腹组之间差异有统计学意义(P<0.05),腹腔镜组和开腹组术后肝功能不全发生率分别为25%和28.57%,二者无显著差异(P<0.05)。结论:腹腔镜肝切除术的肝细胞凋亡增加,但不会加重肝功能损害和术后肝功能不全的发生。

Study on the hepatocellular apoptosis of laparoscopic hepatectomy

Objective:To investigate the hepatocellalar apoptosis of laproscopic hepatic left lateral lobectomy and laparotomy.The relation of the apoptosis and the recovery of liver function at postoperation were also studied.Methods: From Sep.2003 to Jun.2004,24 cases underwent laproscopic hepatic left lateral lobectomy,including 17 cases hepatocellular carcinoma and 7 cases cholecystolithiasis,28 cases underwent laparotomy hepatic left lateral lobectomy,including 19 cases hepatocellular carcinoma and 9 cases cholecystolithiasis were analysized.According to ascites,jaundice and hepatic encephalopathy,the standard of the recovery of hepatic functions at postoperation were divided into good,average,worst group.Results:The apoptosis index(AI) in laproscopic group were significantly higher than that of control group(P<0.05).The rate of dysfunction of liver at postoperation in laproscopic group and laparotomy group were 25% and 28.57% respectively.There were no significant difference(P>0.05).Conclusions: The hepatocyte apoptosis increased at laproscopic hepatectomy patients,but it do not aggrevate the injury of liver function and dysfunction of liver.