腹腔镜肝切除术在肝脏局灶性结节性增生中的应用

目的探讨完全腹腔镜肝切除术治疗肝脏局灶性结节性增生(FNH)的可行性。方法回顾性分析我院2014年3月至2016年9月间施行完全腹腔镜肝切除术的15例FNH的临床资料,其中施行腹腔镜下局部切除术7例,施行肝段或肝叶解剖性切除术8例。断肝方式为超声刀+单极电凝,结合腹腔镜下切割缝合器。结果本组均成功实施腹腔镜肝切除术,无中转开腹病例。平均手术时间95 min(45~150 min),术中平均出血量230 m L(30~560 m L)。全组患者均在手术后24~48 h内恢复胃肠功能,1例出现胸水,经B超定位下穿刺引流3 d后好转,全组无胆漏、术后出血、腹腔内感染与气栓等并发症,术后平均住院时间5.6 d(4~7 d)。结论腹腔镜肝切除术用于治疗肝脏局灶性结节性增生是安全、有效、微创的,可有效用于局部、肝段及半肝切除术,特别适用于肝良性肿瘤。

Application of laparoscopic hepatectomy in focal nodular hyperplasia of liver

Objective To explore the feasibility and effect of total laparoscopic hepatectomy in focal nodular hyperplasia (FNH) of liver.Methods The clinical data of 15 cases in our hospital from Mar. 2014 to Sep. 2016 were analyzed retrospectiveIy. Among them, 7 cases underwent laparoscopic partial resection, 8 cases underwent segmental or hepatic lobectomy. The liver was cut by ultrasonic knfie+single pole coagulation, combined with laparoscopic incision and suture device.Results All laparoscopic surgery was successfully performed without conversion to laparotomy. The average operation time was 95 min (45~150 min), and the average amount of bleeding was 230 mL ( 30~560 mL). Gastrointestinal function recovery was found in postoperative 24~48 h. One case with pleural effusion became better after 3 of days puncture and drainage under B ultrasound. All cases had no complication of bile leakage, bleeding, abdominal infection or gas embolism. The average hospitalization duration was 5.6 d (4~7 d).Conclusion Total laparoscopic hepatectomy for focal nodular hyperplasia of liver is safe, effective, minimally invasive. This operation can be used safely in local, segmental and semi liver resection, especially for benign tumors of liver.