摘要
目的:探讨完全腹腔镜半肝切除术中的止血方法与技巧。方法:回顾分析2010年7月至2014年7月43例患者行腹腔镜半肝切除术的临床资料,总结腹腔镜半肝切除术的手术技巧及术中出血的控制方法。结果:16例患者行腹腔镜右半肝切除术,27例行腹腔镜左半肝切除术,术中9例合并胆总管结石患者行胆总管切开取石T管引流术,无一例中转开腹。手术时间平均(275±55)min,出血量平均(250±75)ml,术后胸腔积液7例,胆漏4例,均经保守治疗治愈。术后平均住院(5.8±1.3)d。结论:随着肝胆外科医生腹腔镜半肝切除术认识的成熟,技术水平的熟练,手术器械的不断改进,完全腹腔镜半肝切除术安全、可行,术中出血不再是阻碍腹腔镜半肝切除术的难题。
Objective： To discuss the methods and skills of bleeding control during laparoscopic hemihepatectomy. Methods：The clinical data of 43 patients who underwent laparoscopic hemihepatectomy between Jul. 2010 and Jul. 2014 were analyzed. The operation skill and the methods of intraoperative bleeding control were summarized. Results： Laparoscopic right hemihepatectomy was performed successfully in 16 cases,27 cases were applied laparoscopic left hemihepatectomy,9 patients who suffered from choledocholithiasis underwent choledocholithotomy T-tube drainage. No cases were converted to open surgery. The operation time was（ 275 ± 55） min,blood loss was（ 250 ± 75） ml. 7 cases of pleural effusion and 4 cases of bile leakage after operation were cured after conservative treatment. Postoperative hospital stay was（ 5. 8 ± 1. 3） d. Conclusions： Along with mature understanding of hepatobiliary surgeon in laparoscopic hemihepatectomy,proficiency in technology,continuous improvement of surgical instruments,laparoscopic hemihepatectomy is safe and feasible,and intraoperative bleeding will no longer be an obstacle in laparoscopic hemihepatectomy.
出处
《腹腔镜外科杂志》
2015年第3期198-200,共3页
Journal of Laparoscopic Surgery
