手助腹腔镜肝切除术的临床体会

目的:评价手助腹腔镜肝切除术的可行性及安全性,并总结其临床经验。方法:回顾分析2009年9月至2012年5月为17例肝占位患者行手助腹腔镜手术的临床资料,结合文献评价手助腹腔镜肝切除术的可行性及安全性。结果:17例手术均成功完成,无中转开腹及围手术期死亡。手术时间120～230 min,平均180 min;术中出血量100～800 ml,平均300 ml。无气体栓塞、胆漏、切口感染等并发症发生。术后住院7～12 d,平均9 d。术后随访2～18个月,无一例腹腔转移及切口转移。结论:掌握并合理选择手术适应证,预防并发症发生,手助腹腔镜肝切除术是安全有效的。

Clinical experience of hand-assisted laparoscopic hepatectomy

Objective:To evaluate the feasibility and safety of the hand-assisted laparoscopic hepatectomy procedure and summarize the experience.Methods:The data of 17 patients who were treated with hand-assisted laparoscopic hepatectomy for liver lesion in our department from Sep.2009 to May 2012 were analysed retrospectively.Results:All the 17 procedures were conducted successfully.The operation time ranged from 120 to 230 min,and the mean time was 180 min.The intra-operative blood loss ranged from 100 ml to 800 ml,and the mean volume was 300 ml.Hospitalization time ranged from 7 to 12 d,and the mean time was 9 d.There were no conversion to laparotomy,gas embolism,bile leak or wound infection.There was no perioperative death.The follow-up time ranged from 2 to 18 months,and no intraperitoneal or wound metastases occurred.Conclusions:Following reasonable indications,hand-assisted hepatectomy is feasible and safe.