切换至 "中华医学电子期刊资源库"

中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (06) : 366 -369. doi: 10.3877/cma.j.issn.1674-6899.2019.06.012

所属专题: 文献

短篇论著

3D腹腔镜肝切除术在肝泡型包虫病中的应用
段帅1, 钟锴1, 马建雄1, 邵英梅1, 蒋铁民1, 郭强1, 冉博1, 吐尔干艾力·阿吉1,()   
  1. 1. 830054 乌鲁木齐,新疆医科大学第一附属医院消化血管中心肝胆包虫科
  • 收稿日期:2019-10-12 出版日期:2019-12-30
  • 通信作者: 吐尔干艾力·阿吉
  • 基金资助:
    国家重点专项(2017YFC0909903); 国家自然科学基金(81660108); 新疆维吾尔自治区"十三五"重点学科(高峰学科)(新教研(2016)7号); 新疆维吾尔自治区自然科学基金(2018D01C220); 省部共建中亚高发病成因与防治国家重点实验室(SKL-HIDCA-2017-1)

Value of 3D laparoscopic hepatectomy for hepatic alveolar echinococcosis

Shuai Duan1, Kai Zhong1, Jianxiong Ma1, Yingmei Shao1, Tiemin Jiang1, Qiang Guo1, Bo Ran1, Aji Tuerganaili·1,()   

  1. 1. Department of Liver and Laparoscopic Surgery, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China
  • Received:2019-10-12 Published:2019-12-30
  • Corresponding author: Aji Tuerganaili·
  • About author:
    Corresponding author: Tuerganaili·Aji, Email:
引用本文:

段帅, 钟锴, 马建雄, 邵英梅, 蒋铁民, 郭强, 冉博, 吐尔干艾力·阿吉. 3D腹腔镜肝切除术在肝泡型包虫病中的应用[J/OL]. 中华腔镜外科杂志(电子版), 2019, 12(06): 366-369.

Shuai Duan, Kai Zhong, Jianxiong Ma, Yingmei Shao, Tiemin Jiang, Qiang Guo, Bo Ran, Aji Tuerganaili·. Value of 3D laparoscopic hepatectomy for hepatic alveolar echinococcosis[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2019, 12(06): 366-369.

目的

分析3D腹腔镜肝切除术(three dimension-laparoscopic hepatectomy,3D-LH)治疗肝泡型包虫病(hepatic alveolar echinococcosis,HAE)的优势及技术要点,为保证手术安全、高效完成,以及促进该手术方式在HAE临床手术治疗中的应用和推广提供参考。

方法

回顾性收集并分析新疆医科大学第一附属医院肝胆包虫科2017年1月至2018年6月行3D-LH的8例HAE患者临床资料,记录手术时间、术中出血量、腹腔引流管留置时间、术后住院时间及并发症发生情况。

结果

8例患者均成功实施3D-LH,其中腹腔镜右半肝切除术4例、左半肝切除术1例、肝段切除术3例,手术时间(327±86)min,术中出血量(421±654)ml,腹腔引流管留置时间(4.6±1.5)d,术后住院时间(6.9±2.7)d;其中1例患者术中出血量较多给予输注悬浮红细胞,1例患者术后并发胸腔积液;所有患者均于术后好转出院。

结论

3D-LH在HAE中的应用是安全的、可行的,具有精准、微创等优势,值得在临床推广和应用,而术中有效控制出血及避免副损伤是保障手术成功实施的关键。

Objective

To analyze the advantages and technical points of 3D laparoscopic hepatectomy in the treatment of hepatic alveolar echinococcosis, in order to ensure the safety and efficiency of the operation and promote the application of the operation in the clinical hepatic alveolar echinococcosis.

Methods

The clinical data of 8 patients with hepatic alveolar echinococcosis who underwent 3D laparoscopic hepatectomy from Jan. 2017 to Jun. 2018 in the Department of Hepatobiliary Echinococcosis, the First Affiliated Hospital of Xinjiang Medical University were collected and analyzed retrospectively, and the operation time, intraoperative bleeding volume, placement time of abdominal drainage tube, postoperative hospitalization time and complications were observed.

Results

8 patients were successfully performed 3D laparoscopic hepatectomy, including 4 cases of laparoscopic right hepatectomy, 1 case of left hepatectomy, 3 cases of segmental hepatectomy. The operation time was (327±86) min, intraoperative bleeding volume (421±654) ml, placement time of abdominal drainage tube (4.6±1.5) d, postoperative hospital stay (6.9±2.7) d, more intraoperative bleeding volume of 1 patient was infused with suspension red blood cells, 1 patien developed pleural effusion. All patients were discharged after operation.

Conclusions

the application of 3D laparoscopic hepatectomy in hepatic alveolar echinococcosis is safe, feasible, accurate and minimally invasive, which is worth clinical promotion and application. The key to ensure the successful implementation of the operation is to effectively control bleeding and avoid side injury.

表1 8例肝泡型包虫病患者的一般资料
[1]
中国医师协会外科医师分会包虫病外科专业委员会. 肝两型包虫病诊断与治疗专家共识(2015版)[J]. 中华消化外科杂志,2015, 14(4):253-264.
[2]
Reich H, Mcglynn F, Decaprio J, et al. Laparoscopic excision of benign liver lesions[J]. Obstetrics & Gynecology, 1991, 78(5):956-958.
[3]
常仁安,陈钟,唐伟东,等. 3D腹腔镜下第Ⅶ段肝癌切除体会[J/CD]. 中华腔镜外科杂志(电子版), 2014,7(6):47-48.
[4]
毛岸荣,潘奇,赵一鸣,等. 腹腔镜肝切除术在肝脏局灶性结节性增生中的应用[J]. 肝胆胰外科杂志,2017, 29(2):103-106.
[5]
Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2804 patients[J]. Annals of Surgery, 2009, 250(5):831-841.
[6]
李建伟,王小军,曹利,等. 2048例腹腔镜肝切除术的临床疗效及经验总结[J]. 中华消化外科杂志,2017,16(16):818-821.
[7]
Wakabayashi G, Cherqui D, Geller DA, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka[J]. Annals of Surgery, 2015, 261(4):619-629.
[8]
Kunert W, Storz P, Kirschniak A. For 3D laparoscopy: a step toward advanced surgical navigation: how to get maximum benefit from 3D vision[J]. Surgical Endoscopy, 2013, 27(2):696-699.
[9]
郑树国,李建伟,肖乐,等. 全腹腔镜联合肝脏离断和门静脉结扎的二步肝切除术治疗肝硬化肝癌[J]. 中华消化外科杂志,2014, 13(7):502-507.
[10]
Xiao L, Li JW, Zheng SG. Totally laparoscopic ALPPS in the treatment of cirrhotic hepatocellular carcinoma[J]. Surgical Endoscopy, 2015, 29(9):2800-2801.
[11]
Wang XT, Wang HG, Duan WD, et al. Pure laparoscopic versus open liver resection for primary liver carcinoma in elderly patients:a single-center, case-matched study[J]. Medicine, 2015, 94(43):1854-1854.
[12]
Martin, Gaillard, Hadrien, et al. Laparoscopic liver resections for hepatocellular carcinoma:current role and limitations[J/CD]. 世界胃肠病学杂志:英文版(电子版), 2014,20(17):4892-4899.
[13]
Ishizawa T, Gumbs AA, Kokudo N, et al. Laparoscopic segmentectomy of the liver: from segment Ⅰ to Ⅷ[J]. Annals of Surgery, 2012, 256(6):959-964.
[14]
Hibi T, Cherqui D, Geller DA, et al. Expanding indications and regional diversity in laparoscopic liver resection unveiled by the international survey on technical aspects of laparoscopic liver resection (INSTALL) study[J]. Surgical Endoscopy, 2016, 30(7):2975-2983.
[15]
Yin Z, Fan X, Ye H, et al. Short-and long-term outcomes after laparoscopic and open hepatectomy for hepatocellular carcinoma: a global systematic review and meta-analysis[J]. Annals of Surgical Oncology, 2013, 20(4):1203-1215.
[16]
Fuks D, Velayutham V, Nomi T, et al. 3D visualization reduces operating time when compared to high-definition 2d in laparoscopic liver resection: acase matched study[J]. Surgical Endoscopy, 2016, 30(1):147-153.
[17]
Komaei I, Navarra G, Currò G. Three-dimensional versus two-dimensional laparoscopic cholecystectomy: a systematic review[J]. J Laparoendosc Adv Surg Tech A, 2017, 27(8):790-794.
[18]
陈钟,陈二林,唐伟东,等. 完全腹腔镜肝部分切除术临床体会[J/CD]. 中华腔镜外科杂志(电子版), 2014,7(1):34-38.
[19]
方驰华,张文宇,杨剑. 三维可视化联合3D腹腔镜右半肝切除术的关键技术和优势[J/CD]. 中华普外科手术学杂志(电子版), 2017,11(5):364-367.
[1] 钟锴, 蒋铁民, 张瑞青, 吐尔干艾力·阿吉, 邵英梅, 郭强. 加速康复外科在肝囊型棘球蚴病肝切除术中的应用分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 425-429.
[2] 冷建军, 朴成林, 司振铎. 胰十二指肠切除术联合小范围肝切除、血管切除重建[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 384-384.
[3] 朴成林, 蓝炘, 司振铎, 李强, 冯健, 安峰铎, 冷建军. 胰十二指肠切除联合肝切除术疗效分析:附5例报告(附视频)[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 363-367.
[4] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[5] 冯旺, 马振中, 汤林花. CT扫描三维重建在肝内胆管细胞癌腹腔镜肝切除术中的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 104-107.
[6] 赖全友, 高远, 汪建林, 屈士斌, 魏丹, 彭伟. 三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 651-654.
[7] 唐梅, 周丽, 牛岑月, 周小童, 王倩. ICG荧光导航的腹腔镜肝切除术临床意义[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 655-658.
[8] 胡森焱, 徐冬, 方健, 谢冬冬, 王财庆. ICG荧光显影Laennec膜入路腹腔镜解剖性肝切除的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 513-516.
[9] 林巧, 周丽. RFA联合LAH术治疗原发性肝癌并门静脉癌栓的临床效果分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 521-524.
[10] 曾繁利, 齐秩凯, 杨贺庆. 两种经Glisson蒂鞘解剖路径肝切除术治疗原发性肝癌的肿瘤学疗效及风险比对[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 525-527.
[11] 张金华, 赵锁. 早期ICC腹腔镜肝切除术不同淋巴结清扫范围的近远期效果对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 578-581.
[12] 杭轶, 杨小勇, 李文美, 薛磊. 可控性低中心静脉压技术在肝切除术中应用的最适中心静脉压[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 813-817.
[13] 焦振东, 惠鹏, 金上博. 三维可视化结合ICG显像技术在腹腔镜肝切除术治疗复发性肝癌中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 859-864.
[14] 吴警, 吐尔洪江·吐逊, 温浩. 肝切除术前肝功能评估新进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 889-893.
[15] 吴雪云, 胡小军, 范应方. 肝切除术中剩余肝再生能力的评估与预测[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 894-897.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?