手助腹腔镜左肝大肿瘤切除：附31例报告

目的 探讨手助腹腔镜左肝大肿瘤切除的可行性和安全性。方法 对31例病变位于左肝的大肿瘤患者（肝细胞癌19例，肝内胆管细胞癌2例，肝海绵状血管瘤7例，肝转移性鳞癌、肝囊腺瘤和肝梭形细胞瘤各1例）采用手助腹腔镜行规则性或不规则性肝切除术。结果 31例手助腹腔镜肝切除均获得成功，包括肝左外叶切除21例，左半肝切除5例，不规则性肝切除5例。瘤体直径平均8．3cm。术中16例行肝门阻断，平均阻断时间14．3min。平均手术时间为109min，平均出血量112mL，术后无严重并发症发生，术后平均住院日为7．8d。结论 只要病例选择得当，手助腹腔镜左肝大肿瘤切除是安全可行的。

Hand-assisted laparoscopic hepatectomy for large left-lobe hepatic tumor: a report of 31 cases

Objective To study the feasibility and safety of hand-assisted laparoscopic hepatectomy for large left-lobe hepatic tumor. Methods Thirty-one patients with large left-lobe hepatic tumor underwent hand-assisted laparoscopic anatomic and non-anatomic hepatectomy, including 19 cases of hepatocellular carcinoma, 2 cases of cholangiocelluar carcinoma, 7 cases of hepatic cavernous hemangioma, 1 case of hepatic metastatic squamous cell carcinoma, 1 case of hepatic cystadenoma and 1 case of hepatic spindle cell tumour. Results The operation procedures were completed safely in all patients, including 5 left hemihepatectomies, 21 left lateral segmentectomies, and 5 atypical hepatectomies. Sixteen cases had occlusion of hepatic hilum during the procedure and the mean occlusion time was 14. 3 minutes. The mean operation time was 109minutes. Mean blood loss was 112ml. The mean tumor size was 8.3 cm. No serious postoperative complications occurred. The mean postoperative hospital stay was 7.8 days. Conclusions Hand- assisted laparoscopic hepatectomy for large hepatic tumor is feasible and safe in selected patients.