手助腹腔镜左肝大肝癌切除22例

目的探讨手助腹腔镜左肝大肝癌切除的可行性和安全性。方法对病变位于左肝的22例大肝癌病人,肝细胞癌19例,肝内胆管细胞癌2例,肝转移性鳞癌1例。采用手助腹腔镜行规则性左半肝或肝左外叶切除术。结果22例手助腹腔镜肝切除均获得成功,肝左外叶切除18例,左半肝切除4例,术中13例行肝门阻断,平均阻断时间15.5 min,平均手术时间为103.2 min,平均出血量106 ml,瘤体大小平均7.8 cm,切除的肝组织最长径平均10.2 cm,术后无严重并发症发生,术后平均进食时间为2.5 d,术后平均住院日为8 d。结论只要病例选择得当,手助腹腔镜左肝大肝癌切除是安全可行的。

HAND-ASSISTED LAPAROSCOPIC HEPATECTOMY FOR LARGE LEFT LIVER CANCER IN 22 CASES

Objective To study the feasibility and safety of hand-assisted laparoscopic hepatectomy for large left liver cancer.Methods 22 patients with large left liver cancer underwent hand-assisted laparoscopic hepatectomy including 19 cases of hepatocellular carcinoma,2 cases of cholangcelluar carcinoma,1 case of hepatic metastatic squamous carcinoma.Results The operation procedures were completed safely in all patients including 4 left hemihepatectomies and 18 left lateral segmentectomies.13 cases with hepatic hilum blocking in the procedure and the mean time was 15.5 minutes.Mean surgical time was 103.2 minutes.Mean blood loss was 106 ml.Mean gross tumor volume was 7.8 cm.Mean maximun diameter of excisional hepatic tissue volume was 10.2 cm.No serious postoperative complications occurred.Mean eating time was 2.5 d.The mean postoperative hospital stay was 8 d.Conclusions Hand-assisted laparoscopic hepatectomy for large liver carcinoma is feasible and safe for selected patients.Laparoscopic hepatectomy is a kind of method which benefit the patient with minimal incision,short operative time and less blood loss.