经脐单孔腹腔镜肝左外叶切除术的临床应用体会.docxVIP

经脐单孔腹腔镜肝左外叶切除术的临床 应用体会(附32例报告) 靳斌杜刚李佳周兵海施彬连孔都姜政辰胡三 元 山东大学齐鲁医院 摘要： 目的:探讨经脐单孔腹腔镜肝左外叶切除术的安全性与可行性。方法：回顾分析 2015年3月至2016年12月为32例患者行经脐单孔腹腔镜肝左外叶切除术的临 床资料。结果:32例均顺利完成手术，无一例增加切口及中转开腹。手术吋间平 均(90. 0±21.2) min,术屮出血量平均(50. 1±12.9) ml,术屮、术后均未输 血，术后无出血、胆漏、腹腔感染等并发症发生;术后第1天拔除胃管，并试饮 水，术后第2天开始进食。术后平均住院(6.0±2. 3) do术后随访6*2个月，无 复发。结论:经脐单孔腹腔镜肝左外叶切除术是安全、可行的，有望成为肝左外 叶切除的金标准。 关键词： 肝肿瘤;肝切除术;腹腔镜检查;经脐;单孔; 作者简介：胡三元，E-ma订：husanyuanl962@hotnia订.com 作者简介：靳斌(1975—)男，山东大学齐鲁医院普通外科副主任医师，副教授, 主要从事肝胆外科的研究. 收稿日期：2017-07-03 基金：山东省科技攻关项目(编号:2016GSF 201082) Clinical application of single-incision transumbilical laparoscopic left lateral hepatic lobectomy: with a report of 32 cases JIN Bin DU Gang LI Jia Department of General Surgery, Qilu Hospital of Shandong University; Abstract： Objective: To investigate the safety and feasibility of single-incision transumbi 1 ical laparoscopic left latera! hepatic 1 obectomy ( STTL-LLHL). Methods: Retrospectivc analysis was performed on the clinical data of 32 patients who underwent SITL-LLHL from Mar. 2015 to Dec. 2016. Results: All the operations were completed successfully in 32 patients, without adding more incisions or conversion to laparotomy. The operation time was (90. 0 土 21. 2) min. The intraoperative bleeding volume was ( 50. 1 土 12. 9) ml. No blood tremsfusion was performed during or after the operation. No postoperative complications such as bleeding, bile leakage or abdominal infection occurred. On the first day after the operation, gastric tube was removed and the patients tried drinking water. Eating began on the second day after surgery. The average hospital stay was ( 6. 0 ± 2. 3) d. The patients were followed up for 6T2 months and no recurrence was reported during that time. Conclusions: SITL-LLHL is safe and feasible, and it may become the gold standard for hepatectomy of the left lateral lobe in the future. Keyword： Liver neoplasms; Ilcpatcctomy; Laporoscopy; Tronsumb订icus; Single—incision; Received： 2017-07-03 自1991年Reich等Hl首次为肝脏病变患者成功施行腹腔镜肝切除术 (la