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目的探讨副肝左动脉在腹腔镜胃癌根治术中的意义。方法回顾性分析2014年1月至2015年6月期间于苏州大学附属第一医院行腹腔镜胃癌根治术的120例胃癌患者的影像学资料及临床资料,总结副肝左动脉在腹腔镜胃癌根治术中的意义及术中处理要点。结果 120例患者中存在副肝左动脉9例(7.5%),术中皆在起点远侧结扎胃左动脉或靠近胃壁结扎胃左动脉的各个分支。术后患者恢复顺利,副肝左动脉组及无副肝左动脉组术前第3天,术后第1、3及7天的总胆红素(TBIL)、谷草转氨酶(AST)和谷氨酸丙氨酸氨基转移酶(ALT)水平比较差异均无统计学意义(P>0.05)。患者术后均未出现肝脓肿及胆汁瘤。结论副肝左动脉变异在临床中的发生率较高,术中需注意对变异副肝左动脉的保护,避免发生肝脓肿、胆汁瘤等并发症。
Objective To investigate the significance of left accessory hepatic artery in laparoscopic radical gastrectomy. Methods We retrospectively analyzed the imaging data and clinical data of 120 patients with gastric cancer undergoing laparoscopic radical gastrectomy at the First Affiliated Hospital of Soochow University from January 2014 to June 2015. The clinical data of the accessory accessory hepatic artery in laparoscopic radical gastrectomy Intraoperative significance and intraoperative treatment points. Results There were 9 cases (7.5%) of the left accessory hepatic artery in 120 patients. All of them were ligated to the left gastric artery distal to the starting point or to the branches of the left gastric artery proximal to the gastric wall. The postoperative recovery was successful. The levels of total bilirubin (TBIL), aspartate aminotransferase (AST) and glutamine on the 3rd, 3rd and 7th day after operation in the left accessory hepatic artery group and the left anterior descending artery group There was no significant difference in the levels of ALT (P> 0.05). None of the patients had liver abscess and bile tumor after operation. Conclusions The incidence of accessory hepatic artery abnormalities in the clinic is high. During the operation, attention should be paid to the protection of the variant left hepatic artery to avoid complications such as liver abscess and bile tumor.