腹腔镜规则性左半肝切除术治疗左肝内胆管结石

目的 探讨完全腹腔镜规则性左半肝切除术治疗左肝内胆管结石的可行性及安全性.方法 2007年1月至2011年6月,区域性控制左半肝入肝血流情况下,运用多种器械对8例左肝内胆管结石患者行完全腹腔镜规则性左半肝切除术.结果 所有患者均成功完成手术,手术时间100~255min(平均173min),术中出血量为100~500mL(平均225mL),术后第1天自行下地活动,术后1~2d拔除胃肠减压管、进食,术后1周左右(平均7.1d)出院,术后无严重并发症发生,术后无结石残留、复发.结论 腹腔镜规则性左半肝切除术治疗左肝内胆管结石是安全和可行的,同时具有微创的优势,是治疗左肝内胆管结石的一种较好选择.

Treatment of hepatolithiasis by laparoscopic anatomical left hemihepatectomy

Objective To evaluate the feasibility and safety of laparoscopic anatomical left hemihepatectomy for the treatment of hepatolithiasis.Methods A total of 8 cases of hepatolithiasis underwent laparoscopic anatomical left hemihepatectomy between January 2007 and June 2011.Severallaparoscopic devices were used for the procedure.The key procedures were anatomical dissection of hepatic vessels followed by clips and transection.Results The total laparoscopic procedure was successfully performed in all of the 8 cases.The operating duration was 100～255 min(mean 173 min),and the intraoperative blood loss was 100～500 mL(mean 225 mL).The patients moved aboot by themselves 1 day after operation,removed nasogastric decompression tube and restored the diet were 1～2 days after operation.No severe complications occurred,no residual stones and recurrence were found.The postoperative hospital stay was about 1 week(mean 7.1 d).Conclusion The laparoscopic anatomical left hemihepatectomy is safe,feasible and of minimal invasion,which can be a preferred approach for the treatment of hepatolithiasis.