腹腔镜肝切除术临床分析(附13份病历)

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  目的 探讨腹腔镜肝切除术(laparoscopic hepatectomy,LH)的安全性,适应证及国内现状.方法 回顾分析宁夏医科大学附属医院自2009年4月至2011年11月完成的13例LH.其中行不规则肝切除10例(伴胆囊切除2例),规则性肝切除3例,肝功能Child-Pugh分级均为A级.结果 13例手术均顺利完成,无中转开腹,手术时间60~180 min(平均95 min),术中出血50~600 ml(平均176 min),术后住院时间6~ 11d(平均8d),均无严重术后并发症发生.术后病理证实肝海绵状血管瘤9例,肝细胞性肝癌4例.13例术后随访1 ~ 12个月(平均7个月),复查肝脏超声或CT及AFP,无肝血管瘤及肝癌复发,无Trocar穿刺通道种植.结论 LH是安全有效的,特别适用于位于肝脏边缘、右肝表面或左半肝的良恶性病变,在我国尚属探索阶段.
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