腹腔镜肝切除术中肝门大血管意外损伤的处理

目的探讨腹腔镜肝切除手术中肝门大血管意外损伤腹腔镜下修复的可行性。方法回顾性分析2005年11月至2009年12月144例腹腔镜肝切除术的临床资料,发生肝门大血管意外3例,其中门静脉主干损伤1例,门静脉右支损伤1例,肝左静脉损伤1例,均行腹腔镜手术修复损伤。结果 3例血管损伤都在腹腔镜下修复,手术时间240～330min,平均290min,术中出血量800～1200ml,平均1000ml,输血400～800ml,平均666.6ml,无死亡及再次手术病例,随访13～15个月,平均13.3个月,未见门静脉血栓形成。结论腹腔镜手术中肝门大血管意外损伤的腔镜下修复是可行的。

Laparoscopic repair on the portal vein injury caused by laparoscope

Objective Portal vein could be injured during the laparoscopic hepatectomy in thehepatic pedicle.This study was to explore the possibility of laproscopic repairing on the injuries duringprocedures.Methods From November 2005 to December 2009,total of 144 laparoscopic hepatectomieswere done.3 injuries were observed,which was 1 portal vein injury,1 right branch injury,and 1 lefthepatic vein injury.Those injuries were repaired by the laparoscopic surgery.Results Three injuries wererepaired by laparoscopy.The average operative time was 290 min（240-330 min）.The average blood lossduring operation was 1000ml（800-1200 ml）.The volume of transfusion required during operation was666.6ml（400-800 ml）.No death and repeated surgery were observed postoperatively.These patients werefollow-up by the average period of 13.3 months（10-15 months）and no venous thrombosis occurred.Conclusions Our data indicated that the repairing by laparoscopy on portal vein injury caused bylaparoscopic procedure was feasible.