腹腔镜切除肝脏良性肿瘤的初步经验

目的 初步分析腹腔镜下肝脏良性疾病手术切除的疗效.方法 2005年4月至2006年12月共对15例肝脏良性肿瘤病人行腹腔镜下肝切除,可分为两类:肝囊肿(n=9例)和肝脏实质肿瘤(n=6例).包括肝孤屯性大囊肿4例、多发囊肿4例、多囊肝1例、血管瘤3例、局灶性结节性增生1例、肝结核瘤1例、肝脂肪瘤I例.结果 所有操作均在全腹腔镜下完成,最大囊肿平均大小13(7～27)cm,实质肿瘤平均大小4.3(2.5～7)cm,无中转开腹手术病例,无输血,平均手术时间88 min.无手术死亡.手术并发症包括手术区积液及肺炎1例(6.7%).术后平均住院天数4(2～7)d.结论 对于肝脏良性肿瘤腹腔镜下肝切除是安全的,腹腔镜外科的技术和器械的迅速发展改变肝脏良性肿瘤治疗模式.

Initial experience in laparoscopic liver resection of benign solid and cystic lesions

Objective To analyze technical feasibility and evaluate outcome of laparoscopic liver resection of benign solid and cystic lesions.Methods Between April 2005 and December 2006,15 patients underwent laparoscopic liver surgery in our hospital.There were two groups of benign lesions:cysts(n=9)and solid tumors(n=6),including solitary giant liver cysts(n=4),multiple simple cysts (n=4),polycystic liver disease(n=1),hemangioma(n=3),focal nodular hyperplasia(n=1),tuberculoma(n=1),and lipoma(n=1).Results The procedures were completed laparoscopically in all patients.Mean size was 13(7-27)cm for liver cysts and 4.3(2.5-7)cm for solid nodules.There was no Conversion to laparotomy.No transfusion occurred.The mean operative time was 88 min.There were no complications after resection of solid tumors.The median length of hospital stay was 4 d.Conclusion Laparoscopic liver surgery can be accomplished safely in selected patients with benign tumors.The technical aspects and devices of laparoscopic liver surgery have evolved rapidly and resulted in a shift in the therapeutic approach to benign liver tumors.