选择性左半肝血流阻断在腹腔镜左半肝切除术中的应用

目的探讨选择性左半肝血流阻断在腹腔镜左半肝切除术中的安全性和可行性。方法回顾性分析2014年1月至2015年12月广东省梅州市人民医院26例腹腔镜左半肝切除术和25例开腹左半肝切除术治疗左肝胆管结石病人的临床资料,术中均采取选择性左半肝入肝血流阻断。对比二组病人的手术时间、术中出血量和术后住院时间。结果腹腔镜组与开腹组相比手术时间短,分别为(338.9±53.6)min比(373.8±54.4)min,两组比较差异有统计学意义(t=-2.311,P=0.025);术中出血量少,分别为(303.8±155.5)ml比(450.2±259.0)ml,差异有统计学意义(t=-2.458,P=0.020);术后住院时间短,分别为(8.5±2.6)d比(11.3±2.3)d,差异有统计学意义(t=-4.223,P=0.000)。术后均未发生肝衰竭。结论选择性左半肝血流阻断在左腹腔镜半肝切除术中的应用安全可行。

Selective left hemihepatic inflow occlusion in laparoscopic left hemihepatectomy

Objective To evaluate the safety and feasibility of selective left hemihepatic inflow occlusion in laparoscopic left hemihepatectomy.Methods Retrospective analysis was conducted on the clinical data of 26 cases of laparoscopic left hemihepatectomy and 25 cases of open left hemihepatectomy for left intrahepatic bile duct stone from Jan.2014 to Dec.2015.All operations were given selective left hemihepatic inflow occlusion.The related outcomes of the two groups were compared,including operation time,intraoperative blood loss and postoperative hospital stay.Results The laparoscopic group had significantly shorter operation time,less intraoperative blood loss and shorter postoperative hospital stay than in the open group [(338.9 ± 53.6) min vs.(373.8 ± 54.4) min,t =-2.311,P=0.025;(303.8±155.5) mLvs.(450.2±259.0) mL,t=-2.458,P=0.020;(8.5± 2.6) days vs.(11.3 ± 2.3) days,t =-4.223,P =0.000].Conclusions Selective left hemihepatic inflow occlusion in laparoscopic left hemihepatectomy is a safe and feasible method.