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中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (04): 208 -211. doi: 10.3877/cma.j.issn.1674-6899.2018.04.005

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腹腔镜肝尾状叶切除的单中心经验
姜政辰 1, 杜刚 1, 施彬垚 1, 孔都 1, 杨金奂 1, 高丽 2, 靳斌 1 , ( ), 胡三元 1   
  1. 1. 250012 济南,山东大学齐鲁医院普外科
    2. 253500 德州,山东德州市陵城区人民医院普外科
  • 收稿日期:2018-04-09 出版日期:2018-08-30
  • 通信作者: 靳斌
  • 基金资助:
    国家科学自然基金(81571367); 山东省科技攻攻关(2016GSF201082)

Single central experience of laparoscopic hepatic caudate lobectomy

Zhengchen Jiang 1, Gang Du 1, Binyao Shi 1, Du Kong 1, Jinhuan Yang 1, Li Gao 2, Bin Jin 1 , ( ), Sanyuan Hu 1   

  1. 1. Qilu Hospital of Shandong University, Jinan 250012, China
    2. General Surgery Department of the People′s Hospital in Lingcheng District, Dezhou 253500 , China
  • Received:2018-04-09 Published:2018-08-30
  • Corresponding author: Bin Jin
  • About author:
    Corresponding author: Jin Bin, Email:
目的

探讨腹腔镜肝尾状叶切除的手术技巧,回顾性分析18例腹腔镜单独肝尾状叶切除术的临床疗效。

方法

2013年1月至2018年3月,18例肝尾状叶肿瘤、血管瘤或局灶性结节性增生的患者采取腹腔镜肝尾状叶切除术,对其临床资料进行分析。

结果

18例腹腔镜肝尾状叶切除术均成功,手术时间75~420 min ,平均126.3 min;术中出血量50~350 ml,平均87.7 ml;术后住院时间6~15 d,平均10.2 d;术后ALT、AST、TBIL在术后1 d上升,但是术后3 d及术后5 d呈下降的趋势。术后无出血、肝衰竭、感染、死亡等严重并发症。

结论

腹腔镜肝尾状叶切除是安全、可行的。

Objective

To explore the surgical technique of laparoscopic hepatic caudate lobectomy, and to analyze the clinical effect of 18 cases.

Methods

From Jan. 2013 to Mar. 2018, 18 patients with hepatic caudate lobe tumor, hemangioma or focal nodular hyperplasia were treated with laparoscopic hepatic caudate lobectomy, and their clinical data were analyzed.

Results

All the 18 cases of laparoscopic hepatic caudate lobectomy were suaessful. The operative time was 126.3(75-420) minutes. The average estimated blood loss was 87.7(50-350)ml, and no blood transfusions were required. The mean duration of hospital stay was 10.2(6-15)days. There was no perioperative complication and patient mortality in this series.

Conclusions

Laparoscopic caudate lobectomy is safe and feasible in selected patients.

图1 操作孔位置
图2 分离肝短血管
图3 "S"蛇形拉钩
图4 围术期肝功能及凝血指标趋势
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