CAJ | 학술논문

目的探讨腹腔镜解剖性右半肝切除术在治疗肝脏肿瘤中的价值.方法回顾性分析2007年10月至2011年10月间在北京大学第三医院住院的16例肝肿瘤患者,因肝脏肿瘤行腹腔镜解剖性右半肝切除术,观察患者手术时间、术中失血量、术后并发症等.断肝方式为超声刀+LigaSure联合分离法,结合腔镜下切割缝合器.结果术后病理证实原发性肝癌(PLC)7例,肝血管瘤6例,结肠癌肝转移2例,胰腺无功能神经内分泌癌肝转移1例.平均手术耗时310 (260 ～450) min,术中出血量约550(220 ～ 1550) ml.3例术后发生胆漏,经充分引流2～3周治愈.平均术后住院时间为7(5～14)d.对肝脏恶性肿瘤患者术后随访15(12 ～52)个月,肿瘤复发4例,其中2例因肿瘤复发转移死亡.结论腹腔镜下解剖性右半肝切除术是一种安全、有效、微创的手术.其不但适用于良性肿瘤,也适用于恶性肿瘤,能达到根治要求.
목적 탐토복강경해부성우반간절제술재치료간장종류중적개치.방법 회고성분석2007년10월지2011년10월간재북경대학제삼의원주원적16례간종류환자,인간장종류행복강경해부성우반간절제술,관찰환자수술시간、술중실혈량、술후병발증등.단간방식위초성도+LigaSure연합분리법,결합강경하절할봉합기.결과 술후병리증실원발성간암(PLC)7례,간혈관류6례,결장암간전이2례,이선무공능신경내분비암간전이1례.평균수술모시310 (260 ～450) min,술중출혈량약550(220 ～ 1550) ml.3례술후발생담루,경충분인류2～3주치유.평균술후주원시간위7(5～14)d.대간장악성종류환자술후수방15(12 ～52)개월,종류복발4례,기중2례인종류복발전이사망.결론 복강경하해부성우반간절제술시일충안전、유효、미창적수술.기불단괄용우량성종류,야괄용우악성종류,능체도근치요구.
Objective To explore the clinical application of laparoscopic anatomical right hemihepatectomy in the treatment of liver tumor.Methods From October 2007 to October 2011,16 cases of laparoscopic anatomical right hemihepatectomy were performed.The data of operative duration,blood loss volume and postoperative complications,etc,were analyzed retrospectively.Parenchyma was transected with a laparoscopic ultrasonic scalpel and ligature and accomplished with an endoscopic linear stapler.Results Among them,postoperative pathologic examinations revealed primary liver carcinoma (n =7),liver hernoangioma (n =6),colon carcinoma with liver metastasis (n =2) and pancreatic non-function neuroendocrine carcinoma with liver metastasis (n =1).The mean volume of blood loss was 550 (200-1550) ml,mean surgical time 310 (260-450) minutes and mean postoperative hospital stay 7 (5-14)days.Postoperative complications included 3 cases of bile leakage recovered after 2-3 weeks by appropriate draining.The patients with malignant tumor were followed up for 15(12-52) months.Recurrence occurred in 4 cases and another 2 died of recurrence and metastasis.Conclusions Laparoscopic anatomical right hemihepatectomy is a safe,feasible and effective procedure for the treatment of benign liver disease and malignant liver neoplasms in properly selected patients.It should be recommended for radical resection of hepatocellular carcinoma.