腹腔镜下肝叶切除术14例报告.pdfVIP

128 实用肝脏病杂志２０15 年3 月第18 卷第2 期 J Prac Hepatol ，Mar. 2015.Vol.18 No.2 ························ ························ ·肝癌· 腹腔镜下肝叶切除术14 例报告* 葛勇胜，荚卫东，许戈良，李建生，马金良，刘文斌 【摘要】目的 探讨腹腔镜肝切除术的可行性和安全性。方法 回顾性分析我院2009年12月至2011年12月 行腹腔镜肝切除术的14例肝占位患者的临床资料，其中原发性肝癌8例，肝转移癌1例，肝局灶性结节性增生1 例，肝局灶性肝细胞脂肪变性1例，肝血管瘤3例。结果 14例均成功施行腹腔镜肝切除术，无中转开腹。其中8例 行腹腔镜辅助肝部分切除术，6例行完全腹腔镜下肝部分切除术。左肝外叶切除3例，左半肝切除1例，肝局部切除 10例。手术时间62～276 min，平均124.2 min。术中出血量40～550 ml，平均155.7 ml，住院时间8～15 d，平均10. 8d。所有患者术后均未发生严重并发症。8例原发性肝癌随访5～25个月，在随访超过1年的4例中，1例肿瘤复 发后死亡，3例健在，1 a生存率为3/4。结论 在掌握好手术指征的情况下，腹腔镜肝切除对于肝脏良恶性肿瘤的 治疗是可行和安全的。 【关键词】 肝肿瘤；腹腔镜；肝切除 DOI：10.3969/j.issn.1672-5069.2015.02.006 Laparoscopic hepatectomy：a report of 14 cases Ge Yongsheng ，Jia Weidong ，Xu Geliang ，et al. Department of Hepatic Surgery ，Anhui Provincial Hospital ，Affiliated to Anhui Medical University ，Hefei ，230001 ，China 【Abstract】Objective To evaluate the feasibility and safety of laparoscopic hepatectomy. Methods The clinical data of 14 patients who underwent laparoscopic hepatectomy in our hospital from December 2009 to De- cember 2011 were retrospectively analyzed. There were eight primary liver cancer，one case of hepatic metastases from rectal cancer，one case of liver focal nodular hyperplasia，one case with fatty degeneration of liver combined with cholecystolithiasis，and three cases of liver cavernous hemangioma. Results All the 14 patients underwent la- paroscopic hepatectomy successfully，without conversion to open surgery. Out of them，eight underwent the assisted laparoscopic hepatectomy and 6 cases underwent total laparoscopic hepatectomy. Three cases were performed hepatic left lateral lobectomy，one cases underwent left hemihepatectomy，and ten cases unde