完全腹腔镜下肝部分切除25例临床探讨

目的总结完全腹腔肝切除的经验。方法2004年12月至今我院共完成25例完全腹腔镜肝切除手术，手术方式包括规则性左肝外叶切除17例，右肝Ⅵ段切除3例，局部切除5例。结果25例均在完全腹腔镜下行肝切除手术，无中转开腹，手术时间60—150分钟，术中出血量50—300ml，术后住院3-9天，术中术后未发现大出血，1例出现少量胆漏，引流7天后愈合。病理报告肝癌15例，良性病变12例。肝癌术后随访2—31个月，未见肝内复发及切口肿瘤种植，所有患者均健康存活。结论在一定条件下完全腹腔镜肝切除治疗肝脏某些疾病是安全、有效、可行的方法。

Clinical approach of total laparoscopic partial hepatectomy in 25 cases

Objective To summarize the experience of total laparoscopic partial hepatectomy （TLH） . Methods From December 2004 up till the precent, 25 cases were underwent TLH in our department. Surgical procedures in cluded 17 cases left lateral liver, 3 cases of Ⅵ segment of liver. 5 cases of local resections.Results laparoscopic hepatectomy was uneventfully accomplished in all the 25 patients. Without conversions to open surgery. The operation time was 60-150 min. and the intraoperative blood loss way 50-300 ml. The postoperative hosptal stay was 3-9 days With no major complications. Biliary fistula occurred in 1 case which were cured by drainage for 7 days. The pathological result included 15 malignant and 12 benign diseases. Follow-up check ups for 2-31 months, revealed no turnout recurrence or incision implantantion. All the patients survived.Conclusions Total laparoscopic hepatectomy can be carried out an effectively for some diseases if it is used properly.