腹腔镜肝尾状叶切除的单中心经验

doi:10.3877/cma.j.issn.1674-6899.2018.04.005

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

所属专题：文献；

论著

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. 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 Jiang¹, Gang Du¹, Binyao Shi¹, Du Kong¹, Jinhuan Yang¹, Li Gao², Bin Jin¹^,^†(), Sanyuan Hu¹

^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: jinbin9494@126.com

全文 ( ) 下载PDF ( ) 导出引用

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。

关键词: 腹腔镜, 肝尾状叶, 肝癌, 肝切除

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.

Key words: Laparoscope, Live caudate lobe, Hepatocarcinoma, Hepatectomy

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

1	Descottes B, Lachachi F, Sodji M, et al. Early experience with laparoscopic approach for solid liver tumors: initial 16 cases[J]. Annals of Surgery, 2000, 232(5):641-645.
2	Umemura A, Suto T, Sasaki A, et al. Pure laparoscopic left hemihepatectomy for hepatic peribiliary cysts with biliary intraepithelial neoplasia[J]. Case Reports in Surgery, 2016, 2016(1):7236427.
3	Satoshi, Ogiso, Etsuro, et al. Laparoscopic liver resection: toward a truly minimallyinvasive approach[J]. World Journal of Gastrointestinal Endoscopy, 2015, 7(3):159-161.
4	黄志强，周宁新，黄晓强，等. 尾状叶外科--肝外科的最后领域[J]. 中华消化外科杂志， 2004, 3(1):1-17.
5	Yamamoto T, Kubo S, Shuto T, et al. Surgical strategy for hepatocellular carcinoma originating in the caudate lobe[J]. Surgery, 2004, 135(6):595-603.
6	Chaib E, Jr RM, Silva FS, et al. Caudate lobectomy: tumor location, topographic classification, and technique using right- and left-sided approaches to the liver[J]. American Journal of Surgery, 2009, 196(2):245-251.
7	Wang Z, Ding Z, Zhou J, et al. Anatomy of the retrohepatic tunnel in a Chinese population and its clinical application in liver surgery[J]. Scientific Reports, 2017, 2017(7):44977.
8	Kogure K, Kuwano H, Yorifuji H, et al. The caudate processus hepatic vein: a boundary hepatic vein between the caudate lobe and the right liver[J]. Annals of Surgery, 2008, 247(2):288-293.
9	Kumon M. Anatomy of the caudate lobe with special reference to portal vein and bile duct[J]. Kanzo, 1985, 26(9):1193-1199.
10	Dulucq JL, Wintringer P, Stabilini C, et al. Isolated laparoscopic resection of the hepatic caudate lobe: surgical technique and a report of 2 cases[J]. Surg Laparosc Endosc Percutan Tech, 2006, 16(1):32-35.
11	Araki K, Fuks D, Nomi T, et al. Feasibility of laparoscopic liver resection for caudate lobe: technical strategy and comparative analysis with anteroinferior and posterosuperior segments[J]. Surgical Endoscopy, 2016, 30(10):4300-4306.
12	蒋超，王广义，王蒙，等. 腹腔镜肝尾状叶腺瘤切除1例[J]. 临床肝胆病杂志， 2012, 28(2):144-145.
13	陈焕伟，邓斐文，李杰原. 腹腔镜肝尾状叶切除(附视频)[J/CD]. 中华肝脏外科手术学电子杂志， 2014，3(5):59-60.
14	Salloum C, Lahat E, Lim C, et al. Laparoscopic isolated resection of caudate lobe (segment 1): a safe and versatile technique[J]. Journal of the American College of Surgeons, 2016, 222(5):61-66.
15	Oh D, Kwon CH, Na BG, et al. Surgical techniques for totally laparoscopic caudate lobectomy[J]. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 2016, 26(9):689-690.
16	曾道炳，邸亮，高大明，等. 完全腹腔镜下肝尾状叶原发性肝癌切除术一例[J]. 中华肝胆外科杂志， 2016, 22(1):60-61.
17	Chen KH, Jeng KS, Huang SH, et al. Laparoscopic caudate hepatectomy for cancer-an innovative approach to the no-man′s land[J]. Journal of Gastrointestinal Surgery, 2013, 17(3):522-526.
18	Gringeri E, Boetto R, Bassi D, et al. Totally laparoscopic caudate lobe resection: technical aspects and literature review[J]. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 2014, 24(6):233-236.
19	Kokkalera U, Ghellai A, Vandermeer TJ. Laparoscopic hepatic caudate lobectomy[J]. Journal of Laparoendoscopic & Advanced Surgical Techniques, 2007, 17(1):36-38.
20	Asahara T, Dohi K, Hino H, et al. Isolated caudate lobectomy by anterior approach for hepatocellular carcinoma originating in the paracaval portion of the caudate lobe[J]. Journal of Hepato-Biliary-Pancreatic Surgery, 1998, 5(4):416-421.
21	Peng SY, Li JT, Mou YP, et al. Different approaches to caudate lobectomy with "curettage and aspiration" technique using a special instrument pmod: a report of 76 cases[J]. World Journal of Gastroenterology, 2003, 9(10):2169-2173.
22	折占飞，罗亿治，王济明. 肝尾状叶手术的应用解剖研究[J]. 肝胆胰外科杂志， 2003, 15(1):21-25.
23	刘树伟，王永贵，杨开清，等. 肝尾状叶的断面解剖及其影象学应用[J]. 中国超声医学杂志， 1991，7(1):1-4.

No related articles found!

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Single central experience of laparoscopic hepatic caudate lobectomy

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Single central experience of laparoscopic hepatic caudate lobectomy