腹腔镜肝部分切除术的临床应用

目的 探讨腹腔镜肝部分切除术临床应用的可行性及疗效分析.方法 对2002年11月至2007年12月在广西医科大学第一附属医院行腹腔镜下肝部分切除术93例病人进行可行性及疗效分析.结果 88例腹腔镜肝部分切除术成功,5例因术中出血中转开腹肝部分切除术.腹腔镜肝部分切除术手术时间30～150 min,平均(60±17)min;术中出血量100～2000 ml,平均(450±98)ml.88例术中阻断肝门15～30 min,平均阻断肝门时间(20±8.5)min,术后无并发症发生,术后24 h均能下床活动,术后1～3 d即能进食,术后住院5～10 d,平均住院(6.6±1.3)d.结论 对位于肝脏边缘、右肝表面或左肝外叶、左半肝、肝右叶下段的良恶性病灶,阻断肝门血流后行腹腔镜肝部分切除是可行和安全的,且具有创伤小恢复快的特点.

Clinical application of laparoscopic partial hepatectomy

Objective To explore the feasibility and the effect of clinic application of laparoscopic partial hepatectomy.Methods The clinical data of 93 cases receiving the procedure in our hospital from November 2002 to December 2007 were retrospectively analyzed.Results Partial hepatectomy was performed successfully under laparoscope in 88 cases and converted to open operation in 5 because of intra-operative hemorrhage.In laparoscopic hepatectomy,the mean operative time was(60±17)min (30～150 min),the mean blood loss was (450±98)ml (100～2000 ml),the mean hepato-portal brock time was (20±8.5)min (15～30 min).No postoperative surgical complications were seen.The patients began to ambulate out of the bed 24 hours and to take food 1-3days after the surgery.The mean length of postoperative hospital stay was (6.6±1.3) d (5 ～ 10 d).Conclusion Laparoseopie partial hepateetomy is safe and feasible by using hepat-portal block instrument and it has the advantage of slighter trauma,faster recovery and shorter hospitalization duration.