CAJ | 학술논문

目的探讨腹腔镜肝切除手术的可行性及相关技术问题.方法回顾性分析2011年2月-2014年3月蚌埠医学院第一附属医院肝胆外科行腹腔镜肝切除术18例患者的临床资料,其中肝细胞肝癌7例,肝海绵状血管瘤3例,肝炎性假瘤2例,肝内胆管结石1例,转移性腺癌、鳞癌各1例,差分化腺癌1例,肝局灶性结节性增生2例.肝脏病灶占位直径1.5 ～10.0 cm.结果 15例成功完成完全腹腔镜下肝切除术,2例行手助腹腔镜探查游离后开腹切除,1例腹腔镜游离肝脏后小切口进腹肝切除.其中右肝段或局部切除术10例,左肝外叶切除术8例.手术时间115 ～ 400 min,术中出血量(527.5±325.4)ml.术后未发生胆漏和出血等并发症,术后平均住院(10±3.7)d.结论腹腔镜肝切除具有创伤小、恢复快的优点,只要合理选择手术适应证,腹腔镜肝切除术是安全、可行的.
목적 탐토복강경간절제수술적가행성급상관기술문제.방법 회고성분석2011년2월-2014년3월방부의학원제일부속의원간담외과행복강경간절제술18례환자적림상자료,기중간세포간암7례,간해면상혈관류3례,간염성가류2례,간내담관결석1례,전이성선암、린암각1례,차분화선암1례,간국조성결절성증생2례.간장병조점위직경1.5 ～10.0 cm.결과 15례성공완성완전복강경하간절제술,2례행수조복강경탐사유리후개복절제,1례복강경유리간장후소절구진복간절제.기중우간단혹국부절제술10례,좌간외협절제술8례.수술시간115 ～ 400 min,술중출혈량(527.5±325.4)ml.술후미발생담루화출혈등병발증,술후평균주원(10±3.7)d.결론 복강경간절제구유창상소、회복쾌적우점,지요합리선택수술괄응증,복강경간절제술시안전、가행적.
Objective To explore the feasibility and techniques in laparoscopic hepatectomy.Methods Clinical data of 18 cases were reviewed and analyzed from Feb.2011 to Mar.2014 in the Hepatobiliary Surgery of the First Affiliated hospital of Bengbu Medical College,including 7 cases of primary liver cancer,3 cases of hepatic cavernous hemangioma,2 cases of inflammatory pseudotumor of liver,1 case of intrahepatolithiasis,1 case of metastatic squamous carcinoma,1 case of metastatic adenocarcinoma,1 case of poorly differentiated adenocarcinoma and 2 cases of focal nodudar hyperplasia.The diameter of hepatic space-occupying lesions was 1.5-10.0 cm.Results Total laparoscopic hepatectomy liver resection was completed successfully in 15 patients,open hepatectomy in 2 patients and mini-incision hepatectomy in 1 patient after hand-assisted laparoscopic exploration and dissociation.A total of 10 segmehtectomies and local resection in right hepatic lesions,8 left lateral lobe hepatectomy.The operation time was 115-400 mins,and the blood loss was(527.5 ± 325.4) ml.All 18 patients had no bile leakage,bleeding or other complications and the postoperative hospital stay was (10 ± 3.7) days.Conclusions Laparoscopic hepatectomy has the advantages of less surgical trauma and rapid postoperative recovery,it is safe and feasible if optimal patients were chosen.