超声刀联合高频电凝断肝法在腹腔镜肝部分切除术中的应用

目的 探讨超声刀联合高频电凝断肝法在腹腔镜肝切除术中的应用价值.方法 回顾性分析浙江省人民医院2007年3月至2009年11月间21例腹腔镜肝切除的临床资料.结果 21例腹腔镜肝部分切除均成功,无一例因出血而中转开腹.术中联合使用超声刀和高频电凝断肝,其中解剖性肝切除9例,局部切除12例,手术时间65～250 min,...

Application of ultrasonic scalpel with electric-cautery in laparoscopic hepatectomy

Objective To summarize the clinical applied value of ultrasonic scalpel and electric-cautery in laparoscopic hepatectomy.Methods From March 2007 to November 2009,21 cases,13 males and 8 females with a mean age of 46 years(range: 25～66),underwent partial laparoscopic hepatectomy in our hospital.Results Combined use of ultrasonic scalpel with electric-cautery,partial laparoscopic liver resection was successful in all patients,with no conversion to open procedures due to massive hemorrhage.The surgical procedures included left hemi-hepatectomy(n=2),left lateral lobectomy(n=4),segmentectomy(n=3) and local resection(n=12).In the study cohort,the operative duration was 126 minutes(range: 65～250 minutes),the median intraoperative blood loss was 360 mL(range: 80～1 200 mL).The postoperative hospital stay was 5 days(range: 3～10 days).The liver function of all patients recovered within 1 week,and no liver failure occurred.Biliary fistula occurred in one case postoperatively,which were cured by drainage for 10 days.The pathological examination found 10 hepatocellular carcinoma,2 metastic liver cancer,4 hepatic hemangioma,2 hepatolithiasis,2 hepatocellular adenoma and 1 focal nodular hyperplasia.Conclusion Laparoscopic hepatectomy is safe and feasible in carefully selected patients with various liver diseases,combined use of ultrasonic scalpel with electric-cautery can help to minimize intraoperative blood loss and shorten operative time.