腹腔镜肝癌切除术28例报告

目的探讨腹腔镜肝癌切除术的适应证和可行性。方法回顾性分析2002年3月至2007年10月完成的腹腔镜肝癌切除术28例患者临床资料。结果28例均成功在腹腔镜下完成手术。对于位于肝左外叶的肿瘤，选择规则性肝左外叶切除术；肿瘤位于肝脏边缘或右肝表面时，选择肝脏不规则切除术。平均手术时间95min（60～150min）。平均术中出血345ml（50～800ml）。切除标本最大体积11cm×9cm×7cm。患者术后24h均能下床活动，术后2～3d即能进食。术后平均住院时间8d（5～15d）。术后病理诊断为原发性肝细胞癌24例，结直肠癌肝转移4例。结论对位于肝脏边缘、右肝表面或者左肝外叶的肝癌行腹腔镜肝癌切除术是安全可行的。

Laparoscopic hepatectomy for liver cancer: A report of 28 cases

Objective To evaluate the feasibility and indications of laparoscopic hepatectomy for liver cancer. Methods In 28 patients with malignant liver tumors, 25 cases were classified as Child A in liver function and 3 cases as Child B. In 24 cases AFP 〉 400μg/L. The tumor size ranged from 2 cm to 11 cm in diameter （ mean 5.5 cm）. For those tumors located in the left lateral segments regular left liver lobe or segment resection were performed ; and in the anterior segments of the right liver partial liver resections were selected. Results All 28 patients were subjected to laparoscopic liver resection successfully. The mean operative time was 95 min （60 - 150 min） ,the mean blood loss was 345 ml （50 - 800 ml ）, and the maximum volume of excised liver was 11 cm × 9 cm × 7 cm. No postoperative surgical complications occurred. The patients began to ambulate out of the bed 24 h and to take food 2 - 3 clays after the surgery. The mean length of postoperative hospital stay was 8 clays （5 - 15 days）. Conclusion Laparoscopic hepatectomy is safe and feasible for malignant tumors located at the border of the liver, the surface of the right lobe or the left lobe. Laparoscopic hepatectomy may be a new alternative for patients with tumors located in the left liver or in the anterior segments of the right liver.