摘要
目的:探讨下腔静脉气囊导管阻断肝静脉流出道在腹腔镜肝切除术中的可行性。方法:用特制的带中央分流管的气囊导管阻断肝静脉血流,观察血流动力学和下腔静脉、肝静脉血流改变,行左半肝切除。结果:受试动物均耐受了腹腔镜左半肝切除。实验过程中平均动脉压轻度下降,心输出量下降至基础值的70％,中心静脉压下降明显,气囊内液体排除后,血流动力学指标均立即恢复正常。气囊充盈后,肝静脉血流几乎消失,下腔静脉中有部分血流通过。结论:用带中央分流的气囊导管阻断肝静脉血流行腹腔镜肝切除术安全、可行。
Objective: To assess the feasibility of using a balloon catheter to occlude hepatic veins during laparoscopic hepatectomy in a porcine model.Methods: A newly developed balloon catheter, with a central shunt lumen, was inserted into the retrohepatic inferior vena cava through the femoral veins positioned under fluoroscopy. Hemodynamic changes were measured after balloon inflation and deflation 10,20,30 minutes respectively. Inferior vena cava and left paramedial hepatic vein blood flow were measured using a laparoscopic doppler ultrasound during the balloon inflation. The left and left paramedial liver lobes were resected laparoscopically.Results: Animals tolerated well all the procedures. Slightly decreased of mean arterial pressure was found during thirty minutes inflation of the balloons. Cardiac output decreased to approximately seventy percent of the original values. Central venous pressure was found decreased greatly. All the changes became normal immediately when the balloon was deflated. The hepatic venous blood flow almost disappeared when the balloon was inflated. The left two lobes were successfully resected laparoscopically as the balloon was inflated, after which only slight hemodynamic changes were found. Conclusion: Hepatic outflow occlusion with a balloon catheter during laparoscopic hepatectomy in a porcine model is safe and effective. It is possible to use this technique in human laparoscopic hepatectomy.
出处
《腹腔镜外科杂志》
2001年第3期129-132,共4页
Journal of Laparoscopic Surgery
关键词
腹腔镜术
肝切除术
气囊导管
肝静脉
Lapatoscopy
Hepatectomy
Balloon catheter
Hepatic veins
