摘要
目的探讨腹腔镜规则性肝切除的解剖基础与技术问题。方法 2 0 0 2年 7月至2 0 0 2年 11月 ,治疗原发病灶位于左半肝但未侵及左肝门的原发性肝癌 4例、肝血管瘤 2例、肝囊肿伴感染 1例。肝切除步骤包括显露第 1肝门 ,游离肝周韧带 ,解剖并离断 2、3级肝门 3管 ,解剖第 2肝门并夹闭肝左静脉 ,离断肝实质和切断肝左静脉。结果 7例完全在腹腔镜下完成手术 ,左半肝切除 2例、左外叶切除 4例、肝方叶切除 1例。均成功地在矢状部对 2至 3级肝门的 3管进行解剖和离断。手术时间为 15 0～ 32 0min ,平均 (2 5 3± 5 9)min。出血量 2 0 0～ 10 0 0ml,平均 (4 5 0± 2 6 1)ml。结论腹腔镜规则性左肝切除术是安全可行的 ,对 2级肝门 3管的解剖和离断是行肝段或左半肝切除时控制出血的关键。
ObjectiveTo evaluate the feasibility of laparoscopic anatomical hepatectomy. Methods From Jul. to Nov. 2002, laparoscopic anatomical hepatectomy was performed in 7 cases including 4 cases of primary liver cancer,2 cases of liver hamangioma and 1 case of infected liver cyst. Resection was undertaken at the exclusion of hepatopetal blood flow by mobilizing the liver,dissecting grade 2 and 3 porta hepatic vessels and left hepatic vein. ResultsThe total laparoscopic procedure was successful in all 7 patients, including left hemihepatectomy in 2 cases, left lateral hepatectomy in 4 cases, and quadrate lobectomy in one. Operation time averaged at (253±59) min. The average intraoperative blood loss was ( 450± 261) ml. The key procedures are anatomical dissection of grade 2～3 porta hepatic vessels followed by clips and transection. ConclusionLaparoscopic anatomical hepatic resections are technically feasible in hands with laparoscopic expertise.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第7期403-405,共3页
Chinese Journal of General Surgery
关键词
腹腔镜
肝切除
解剖基础
技术问题
Surgical procedures, laparoscopic
Hepatectomy
Anatomy
