手助腹腔镜肝脾联合切除3例

目的探讨手助腹腔镜肝脾联合切除的可行性。方法采用手助腹腔镜（Hand—port）行肝脾联合切除术，选择剑突下正中或右肋缘下手助切口，手助下超声刀分离脾周韧带，Endo-GIA断脾蒂，采用超声刀、生物夹夹闭断肝，肝断面间断缝合闭合。结果3例手术均获得成功，手术时间分别为130、115、145min，术中出血量分别为350、50、150ml。3例术后未发生严重并发症，术后住院日分别为9、7、11d。3例分别随访6、23、5个月，肿瘤无复发。结论手助腹腔镜肝脾联合切除术安全、可行。

Hand-assisted laparoscopic hepatectomy combined with splenectomy: A report of 3 cases

Objective To study the feasibility and safety of hand-assisted laparoscopic hepatectomy combined with splenectomy. Methods Hand-assisted laparoscopic hepatectomy combined with splenectomy was performed in 3 patients. A midline epigastric or right subcostal incision was made for hand-assisted port. The attachments of the spleen were dissected with a harmonic scalpel and the pedicle of the spleen was severed with the Endo-GIA. The transection of the liver was conducted using the harmonic scalpel dissection and nonabsorbable polymer clipping. The cut surface of the liver was closed by interrupted sutures. Results The operation was successfully completed in all the 3 patients. The surgical time was 130 min, 115 min, and 145 min, and the blood loss was 350 ml, 50 ml, and 150 ml, respectively. No serious postoperative complications occurred. The postoperative hospital stay was 9, 7, and 11 days, respectively. Follow-up observations for 6, 23, and 5 months showed no recurrence. Conclusions Hand-assisted laparoscopic hepatectomy combined with splenectomy is feasible and safe in selected patients .