CAJ | 학술논문

目的：探讨腹腔镜肝切除术的可行性和安全性。方法回顾性分析我院2009年12月至2011年12月行腹腔镜肝切除术的14例肝占位患者的临床资料，其中原发性肝癌8例，肝转移癌1例，肝局灶性结节性增生1例，肝局灶性肝细胞脂肪变性1例，肝血管瘤3例。结果14例均成功施行腹腔镜肝切除术，无中转开腹。其中8例行腹腔镜辅助肝部分切除术，6例行完全腹腔镜下肝部分切除术。左肝外叶切除3例，左半肝切除1例，肝局部切除10例。手术时间62～276 min，平均124.2 min。术中出血量40～550 ml，平均155.7 ml，住院时间8～15 d，平均10.8 d。所有患者术后均未发生严重并发症。8例原发性肝癌随访5～25个月，在随访超过1年的4例中，1例肿瘤复发后死亡，3例健在，1a生存率为3/4。结论在掌握好手术指征的情况下，腹腔镜肝切除对于肝脏良恶性肿瘤的治疗是可行和安全的。
목적：탐토복강경간절제술적가행성화안전성。방법회고성분석아원2009년12월지2011년12월행복강경간절제술적14례간점위환자적림상자료，기중원발성간암8례，간전이암1례，간국조성결절성증생1례，간국조성간세포지방변성1례，간혈관류3례。결과14례균성공시행복강경간절제술，무중전개복。기중8례행복강경보조간부분절제술，6례행완전복강경하간부분절제술。좌간외협절제3례，좌반간절제1례，간국부절제10례。수술시간62～276 min，평균124.2 min。술중출혈량40～550 ml，평균155.7 ml，주원시간8～15 d，평균10.8 d。소유환자술후균미발생엄중병발증。8례원발성간암수방5～25개월，재수방초과1년적4례중，1례종류복발후사망，3례건재，1a생존솔위3/4。결론재장악호수술지정적정황하，복강경간절제대우간장량악성종류적치료시가행화안전적。
Objective To evaluate the feasibility and safety of laparoscopic hepatectomy. Methods The clinical data of 14 patients who underwent laparoscopic hepatectomy in our hospital from December 2009 to De-cember 2011 were retrospectively analyzed. There were eight primary liver cancer,one case of hepatic metastases from rectal cancer,one case of liver focal nodular hyperplasia,one case with fatty degeneration of liver combined with cholecystolithiasis,and three cases of liver cavernous hemangioma. Results All the 14 patients underwent la-paroscopic hepatectomy successfully,without conversion to open surgery. Out of them,eight underwent the assisted laparoscopic hepatectomy and 6 cases underwent total laparoscopic hepatectomy. Three cases were performed hepatic left lateral lobectomy,one cases underwent left hemihepatectomy,and ten cases underwent partial resection. The av-erage operation time was 124.2 min (62~276 min),the intraoperative average hemorrhage was 155.7 ml (40~550 ml),and the mean hospital stay was 10.8 d (8~15 d). No serious complications were found in all 14 patients. Eight patients who had primary liver cancer were followed-up for 5 to 25 months. Of the four patients with prima-ry liver cancer who were followed-up for more than one year,one patient died of cancer recurrence and the other three patients remained survival. The 1 a survival rates was 3/4. Conclusions Laparoscopic hepatectomy is feasi-ble and safe for benign and malignant tumors of liver under the premise of meeting operation indications.