CAJ | 학술논문

回顾分析23例行腹腔镜右肝困难部位肝切除患者的临床资料.病灶分别位于Ⅵ/Ⅶ段交界、Ⅶ段、Ⅷ段、Ⅶ/Ⅷ段交界以及Ⅴ/Ⅷ段交界.术中均通过超声准确定位,并利用超声吸引刀(CUSA)游离所需切除肝段或联合肝段的Glisson系统行高选择性血流阻断.全部病例肝切除均经腹腔镜完成,无中转开腹及围手术期死亡.CUSA联合术中超声手术时间短,能有效减少术中出血,提高手术成功率,安全可行,重复性强,有利于促进腹腔镜手术在困难部位肝切除应用方面的开展.
회고분석23례행복강경우간곤난부위간절제환자적림상자료.병조분별위우Ⅵ/Ⅶ단교계、Ⅶ단、Ⅷ단、Ⅶ/Ⅷ단교계이급Ⅴ/Ⅷ단교계.술중균통과초성준학정위,병이용초성흡인도(CUSA)유리소수절제간단혹연합간단적Glisson계통행고선택성혈류조단.전부병례간절제균경복강경완성,무중전개복급위수술기사망.CUSA연합술중초성수술시간단,능유효감소술중출혈,제고수술성공솔,안전가행,중복성강,유리우촉진복강경수술재곤난부위간절제응용방면적개전.
A retrospective study was conducted based on the clinical data of 23 patients who underwent laparoscopic liver resection with tumor in the difficult part of right liver.Localization and edge of the lesion and Glisson system of the liver segment resection required were all marked by laparoscopic ultrasound, followed by clamping and resecting with cut-ultrasound aspiration (CUSA) the inflow pedicle of liver segment.Total laparoscopic liver resection was successfully carried out in all patients with reduced operation time and blood loss, and fast recovery.There was no perioperative death.Intraoperative ultrasound combined with CUSA in laparoscopic hepatectomy for tumors located in the difficult segments of right liver is a feasible, safe and repeatable therapeutic option.