摘要
目的探讨全腹腔镜下Bismuth Ⅰ型肝门部胆管癌根治术的安全性、可行性。方法回顾性分析2011年1月~2016年1月7例全腹腔镜下Bismuth Ⅰ型肝门部胆管癌根治术的资料,全腹腔镜下肝外胆道切除,胆道重建,清扫第8、9、12、13组淋巴结。结果 7例手术均顺利完成。手术时间3.5~5 h,(4.13±0.53)h;术中出血量85~250 ml,(156.4±67.6)ml。无胆漏、腹腔感染、术后出血等并发症。术后住院时间9~14 d,(10.7±2.0)d。术后病理均提示胆管中分化腺癌,胆管上下切缘阴性,R0切除,清扫淋巴结7~15枚,平均9.3枚,均未见癌转移。术后随访12~18个月,影像学检查均未见肿瘤复发,血癌胚抗原(CEA)和CA19-9正常。结论术者熟练掌握全腹腔镜下消化道重建及淋巴结清扫等的情况下,全腹腔镜下BismuthⅠ型肝门部胆管癌根治术是安全、可行的。
Objective To explore the safety and feasibility of total laparoscopic Bismuth type I radical resection of hilar cholangiocarcinoma.Methods From January2011to January2016,a total of7patients with hilar cholangiocarcinoma received total laparoscopic Bismuth type I radical resection of hilar cholangiocarcinoma.Their clinical data were analyzed retrospectively.The total laparoscopic extrahepatic biliary resection was carried out,with biliary tract reconstruction and dissection of the8,9,12,and13groups of lymph nodes.Results The operation was successfully carried out in all the7cases.The operation time was3.5-5h(mean,4.13±0.53h).The blood loss was85-250ml(mean,156.4±67.6ml).No postoperative complications of biliary leakage,abdominal infection,or bleeding occurred.The time of hospital stay was9-14d(mean,10.7±2.0d).The results of postoperative pathological examinations showed moderately differentiated adenocarcinoma.The resection margins of bile ducts were negative,achieving a R0resection.A total of7-15lymph nodes were collected(mean,9.3),and no metastasis was found.The postoperative follow-up for12-18months with radiographic examinations showed no obvious tumor recurrence,as well as tumor makers carcinoembryonic antigen(CEA)and CA19-9being normal.Conclusion It is safe and feasible to complete laparoscopic Bismuth I hilar cholangiocarcinoma radical operation on the basis of skillful performance of laparoscopic digestive tract reconstruction and lymph node dissection.
作者
朱鸿超
匡天佐
张福扬
胡昌昌
周龙飞
黄明文
Zhu Hongchao;Kuang Tianzuo;Zhang Fuyang(Department of Hepatobiliary Surgery, Second Affiliated Hospital of Nanchang University,Nanchang 330006 , China)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第3期274-276,288,共4页
Chinese Journal of Minimally Invasive Surgery
基金
江西省自然科学基金(20142BAB205108)
