中华腔镜外科杂志（电子版）
中華腔鏡外科雜誌（電子版）
중화강경외과잡지（전자판）
CHINESE JOURNAL OF LAPAROSCOPIC SURGERY ( ELECTRONIC EDITION)
2014年
1期
18-22
,共5页
陈焕伟%邓斐文%王峰杰%胡健垣
陳煥偉%鄧斐文%王峰傑%鬍健垣
진환위%산비문%왕봉걸%호건원
肝外格立森鞘外方法%右肝蒂%腹腔镜%右肝切除术
肝外格立森鞘外方法%右肝蒂%腹腔鏡%右肝切除術
간외격립삼초외방법%우간체%복강경%우간절제술
Extraheptic Glisson dissection technique%Right liver pedicel%Laparoscopy%Right hemihepatectomy
目的：探讨腹腔镜下肝外格立森鞘外右肝蒂血流阻断技术应用的可行性和安全性。方法从2013年3至8月，我们对8例右肝肿瘤患者实施了腹腔镜肝切除术，其中原发性肝癌3例，肝肉瘤样癌1例，肝血管上皮样肿瘤1例，肝血管瘤2例，肝转移癌1例。术中控制出血方法采用了肝外格立森鞘外右肝蒂血流阻断技术，通过降低前肝门板，分离后肝门板，最后通过直角钳完成肝外右Glisson 鞘外的分离及预阻断。结果实施右半肝切除3例，肝5、6段切除2例，肝6、8段切除1例，肝6段切除2例，分离肝门板时间15～20 min，无出血及胆漏等并发症。结论腹腔镜下经肝门板右半肝血流阻断技术安全可行、操作简单、可重复性强，该技术的应用有利于促进腹腔镜右肝切除的开展。
目的：探討腹腔鏡下肝外格立森鞘外右肝蒂血流阻斷技術應用的可行性和安全性。方法從2013年3至8月，我們對8例右肝腫瘤患者實施瞭腹腔鏡肝切除術，其中原髮性肝癌3例，肝肉瘤樣癌1例，肝血管上皮樣腫瘤1例，肝血管瘤2例，肝轉移癌1例。術中控製齣血方法採用瞭肝外格立森鞘外右肝蒂血流阻斷技術，通過降低前肝門闆，分離後肝門闆，最後通過直角鉗完成肝外右Glisson 鞘外的分離及預阻斷。結果實施右半肝切除3例，肝5、6段切除2例，肝6、8段切除1例，肝6段切除2例，分離肝門闆時間15～20 min，無齣血及膽漏等併髮癥。結論腹腔鏡下經肝門闆右半肝血流阻斷技術安全可行、操作簡單、可重複性彊，該技術的應用有利于促進腹腔鏡右肝切除的開展。
목적：탐토복강경하간외격립삼초외우간체혈류조단기술응용적가행성화안전성。방법종2013년3지8월，아문대8례우간종류환자실시료복강경간절제술，기중원발성간암3례，간육류양암1례，간혈관상피양종류1례，간혈관류2례，간전이암1례。술중공제출혈방법채용료간외격립삼초외우간체혈류조단기술，통과강저전간문판，분리후간문판，최후통과직각겸완성간외우Glisson 초외적분리급예조단。결과실시우반간절제3례，간5、6단절제2례，간6、8단절제1례，간6단절제2례，분리간문판시간15～20 min，무출혈급담루등병발증。결론복강경하경간문판우반간혈류조단기술안전가행、조작간단、가중복성강，해기술적응용유리우촉진복강경우간절제적개전。
Objective To explore the feasibility and safety of the extraphepatic Glisson right liver pedicellblood flow block technique applied in the laparoscopic right hepatectomy. Methods Eight patients with right liver neoplasms underwent laparoscopic hepatectomy from March to August 2013,including three cases of hepatocellular carcinoma,one liver carcinoma sarcomatodes,one liver blood vessel epithelium like tumor,one case of hepatic haemangioma,one cases of hepatic metstasic carcinoma. Extraphepatic Glisson right liver pedicellblood flow block technique was applied for the controlling hemorrhage introperaction, which was through lowering the anterior porta hepatic plate,dissection the posterior porta hepatic plate, and passing the right angle forceps finished the extrohepatic Glisson dissection and righ liver pedicellblood flow block. Results Right hemihepatectomy were performed in three cases,two cases underwent segment V+VI hepatectomy, one case with segment VI+VIII hepatectomy and two cases with segment VI hepatectomy. The time for the dissection of the porta hepatic plate was 15-20 minutes,and there was no hemorrhage and bile leakage complications. Conclusion The right hemihepatic blood flow block technique through the porta hepatic plate applied in the laparoscopic right hepatectomy was safe, simple and repeatable procedure,which should in favour of facilitating the laparoscopic right hepatectomy.
