摘要
目的探讨腹腔镜肝切除术治疗肝血管瘤的适应证、技术要点和疗效。方法回顾性分析本中心2014年1~12月期间收治的78例肝血管瘤患者的病例资料。结果 78例患者中77例成功实施全腹腔镜肝切除术,1例中转开腹。手术方式：腹腔镜解剖性肝切除术35例,其中左肝外叶切除术23例,左半肝切除术4例,右半肝切除术3例,肝Ⅲ段切除术1例,肝Ⅵ段切除术1例,肝Ⅵ、Ⅶ段切除术2例,左肝外叶联合Ⅵ、Ⅶ段切除术1例;非解剖性肝切除术43例。手术时间（163.6±62.3）min,术中出血量（273.6±282.4）m L。全组无手术死亡,1例术后出现功能性肠梗阻,3例术后出现胸腔积液,经保守治疗均顺利恢复,术后住院时间（7.2±2.5）d,术后病理诊断均为肝海绵状血管瘤。结论腹腔镜肝切除术治疗肝血管瘤安全、可行,具有创伤小、恢复快、切口美容等近期疗效优势,该技术的关键在于严格把握手术指征,正确选择肝实质离断平面,有效控制入肝血流及妥善处理肝断面。
Objective To investigate indications, technical points, and outcomes of laparoscopic liver resection in treatment for hepatic hemangioma. Method The clinical data of 78 patients with hepatic hemangioma underwent laparoscopic liver resection in our institute from January 2014 to December 2014 were analyzed retrospectively. Results Seventy-seven patients were underwent laparoscopic liver resection successfully, 1 patient was conversed to open procedure.Operation method： laparoscopic anatomical liver resections were performed in 35 patients including 23 patients with left lateral segmentectomy, 4 patients with left hemihepatectomy, 3 patients with right hemihepatectomy, 1 patient with Ⅲsegmentectomy, 1 patient with Ⅵ segmentectomy, 2 patients with Ⅵ and Ⅶ segmentectomy, 1 patient with left lateral segmentectomy combined with Ⅵ and Ⅶ segmentectomy. Laparoscopic non-anatomical liver resection were performed in 43 patients. The operation time was（163.6 ±62.3） min, the intraoperative blood loss was（273.6±282.4） m L. No operative death occurred. One patient with postoperative functional bowel obstruction and 3 patients with pleural effusion had been recorded. All the patients recovered well. The postoperative hospital stay was（7.2±2.5） d. The results of postoperative pathology confirmed that all the tumors were hepatic cavernous hemangiomas. Conclusions Laparoscopic liver resection for hepatic cavernous hemangioma is a safe and feasible method with small trauma, rapid recovery, cosmetic incision. Key of this technology is to strictly select surgical indications, to transect liver parenchyma along right plane, effective control of hepatic blood inflow, and properly management of cutting surface of liver.
出处
《中国普外基础与临床杂志》
CAS
2016年第2期156-159,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
肝血管瘤
腹腔镜
肝切除术
Hepatic hemangioma
Laparoscope
Liver resection
