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腹腔镜肝切除术的手术入路探讨
作者姓名:Liu R  Huang ZQ  Zhou NX  Huang XQ  Wang YH  Jiang K  Xiang X
作者单位:100853,北京,解放军总医院肝胆外科
摘    要:目的 介绍完全腹腔镜下肝切除手术的入路,以期进一步提高腹腔镜肝切除的水平。方法 在不阻断全肝血流的情况下,应用多种器械于完全腹腔镜下进行肝切除27例,其中原发性肝癌14例、肝囊肿伴感染1例、肝门部胆管癌1例、肝脏血管瘤6例、肝脏局灶结节性增生1例、炎性肉芽肿1例、肝脏腺瘤1例、肝脓肿2例。结果27例手术均在完全腹腔镜下顺利完成,平均手术时间184 min,平均出血量441 ml。术后平均住院5d,腹腔引流管放置时间2~4d。未发生胆漏、出血、感染等并发症。结论 选择合适的腹腔镜下手术入路对于手术的成功具有重要作用。利用现有的手术器械条件及在不阻断全肝血流的情况下,腹腔镜肝切除是安全可行的。该方法是病灶局限于左半肝及部分右肝病例的首选术式之一。

关 键 词:腹腔镜  肝切除术  手术入路  解剖结构  微创外科

Operational line of laparoscopic liver resections
Liu R,Huang ZQ,Zhou NX,Huang XQ,Wang YH,Jiang K,Xiang X.Operational line of laparoscopic liver resections[J].National Medical Journal of China,2004,84(3):219-221.
Authors:Liu Rong  Huang Zhi-qiang  Zhou Ning-xin  Huang Xiao-qiang  Wang Yue-hua  Jiang Kai  Xiang Xin
Institution:Department of Hepatobiliary Surgery, General Hospital of the People's Liberation Army, Beijing 100853, China. dr_rong@yahoo.com
Abstract:OBJECTIVE: To evaluate the feasibility and indications of laparoscopic liver resections. METHODS: Twenty-seven patients with liver lesions, 17 men and 10 women, aged 31 - 67, including 14 cases of primary liver cancer, 6 cases of liver hemangioma, 2 cases of liver abscess, 1 case of hilar carcinoma, 1 case of hepatic adenoma, 1 case of hepatic focal nodular hyperplasia, 1 case of liver inflammatory granuloma, and 1 case of infected liver cyst, underwent laparoscopic liver resection, partial liver resection in 17 cases and anatomical left liver resections in 10 cases, consecutively from July 2002 to April 2003. The clinical data were analyzed. RESULTS: All of the 27 operations were performed smoothly with an average operation time of 184 min and the average blood loss during operation of 441 ml. The average postoperative hospital stay was 5 days. No complication occurred. CONCLUSION: A promising minimally invasive technique, laparoscopic liver resection can be carried out safely and effectively by experienced surgeons as one of the first choices for the loci limited to left liver and part of the loci in right liver.
Keywords:Laparoscopy  Hepatectomy  Anatomy
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