CAJ | 학술논문

目的探讨改良腹腔镜肝右后叶血管瘤切除的可行性、安全性.方法回顾性分析齐鲁医院2012年11月至2015年3月35例肝右后叶血管瘤患者行改良腹腔镜肝切除的临床资料.35例患者术前均经影像学(腹部超声、计算机化断层显像及强化CT、核磁共振显像)诊断为肝右后叶血管瘤,所有患者凝血功能、肝功能及AFP均正常.结果 35例肝切除手术全部在腹腔镜下完成,无一中转开腹.术中28例需要阻断肝门,平均阻断时间为(21.26.2)min.手术平均时间为(143.4 ±24.0)min,术中出血平均为(168.0±143.2)ml、术中及术后均未输血.术后平均住院(10.4 ±2.2)d,引流管平均留置时间为(5.4±1.1)d.术后无大出血等严重并发症发生,30及90天病死率为0.结论肝右后叶血管瘤位置靠后,行腹腔镜肝血管瘤切除术较困难.采用我科改良的腹腔镜方法行腹腔镜肝右后叶血管瘤切除术安全、可行.
목적 탐토개량복강경간우후협혈관류절제적가행성、안전성.방법 회고성분석제로의원2012년11월지2015년3월35례간우후협혈관류환자행개량복강경간절제적림상자료.35례환자술전균경영상학(복부초성、계산궤화단층현상급강화CT、핵자공진현상)진단위간우후협혈관류,소유환자응혈공능、간공능급AFP균정상.결과 35례간절제수술전부재복강경하완성,무일중전개복.술중28례수요조단간문,평균조단시간위(21.26.2)min.수술평균시간위(143.4 ±24.0)min,술중출혈평균위(168.0±143.2)ml、술중급술후균미수혈.술후평균주원(10.4 ±2.2)d,인류관평균류치시간위(5.4±1.1)d.술후무대출혈등엄중병발증발생,30급90천병사솔위0.결론 간우후협혈관류위치고후,행복강경간혈관류절제술교곤난.채용아과개량적복강경방법행복강경간우후협혈관류절제술안전、가행.
Objective To study the feasibility and safety of modified laparoscopic liver resection for hemangioma in the right posterior liver section.Methods Between November 2012 and March 2015, a retrospective study was carried out on 35 patients with hepatic hemangioma in the right posterior liver section diagnosed on preoperative abdominal ultrasound, computed tomography and/or magnetic resonance imaging, and received modified laparoscopic liver resection.These patients had good liver function, coagulation function and normal level of α-fetoprotein.Results Modified laparoscopic liver resection of hemangiomas in the hepatic right posterior section was performed successfully.No patients had to be converted to open surgery.In 28 patients, portal triad clamping with a mean clamp time of (21.2 ± 6.2) min was required.The mean operating time was (143.4 ±24.0) min.The mean amount of bleeding was (168.0 ± 143.2) ml.No blood transfusion was required in these patients during the intra-operative and post-operative periods.The mean length of hospital stay was (10.4 ±2.2) days and the mean duration of abdominal drainage was (5.4 ± 1.1) days.No patients developed severe complications.The 30-day mortality and the 90-day mortality were both 0.Conclusions Laparoscopic hepatectomy for hemangioma in the right posterior liver section was difficult because of deep location of the lesions which had a tendency to bleed.We successfully performed laparoscopic liver resection in these patients using our modified surgical techniques which have been found to be safe and feasible.