Cho A, Asano T, Yamamoto H, Nagata M, Takiguchi N, Kainuma O, Souda H, Gunji H, Miyazaki A, Nojima H, Ikeda A, Matsumoto I, Ryu M, Makino H, Okazumi S
Department of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba, 260-8717, Japan.
Surg Endosc. 2007 Aug;21(8):1466-8. doi: 10.1007/s00464-007-9253-5. Epub 2007 Mar 14.
Although many reports have described laparoscopic minor liver resections, major hepatic resection, including right or left lobectomy, has not been widely developed because of technical difficulties. This article describes a new technique for performing laparoscopy-assisted right or left hepatic lobectomy using hilar Glissonean pedicle transection. Laparoscopic mobilization of the right or left hepatic lobe is performed, including dissection of the round, faliciform, triangular, and coronary ligaments. The right or left Glissonean pedicle is encircled and divided laparoscopically. A parenchymal dissection is then performed though the upper median or right subcostal incision, through which the resected liver is removed. We successfully performed this procedure in 6 patients without blood transfusion or serious complications. Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection can be feasible and safe in highly selected patients.
尽管许多报告描述了腹腔镜下小肝切除术，但包括右或左肝叶切除术在内的大肝切除术由于技术困难尚未得到广泛开展。本文描述了一种使用肝门部Glisson蒂横断术进行腹腔镜辅助右或左肝叶切除术的新技术。进行右或左肝叶的腹腔镜游离，包括切断圆韧带、镰状韧带、三角韧带和冠状韧带。在腹腔镜下环绕并切断右或左Glisson蒂。然后通过上腹部正中或右肋缘下切口进行肝实质离断，切除的肝脏通过该切口取出。我们成功地为6例患者实施了该手术，无一例输血或出现严重并发症。对于经过严格筛选的患者，使用肝门部Glisson蒂横断术的腹腔镜辅助肝叶切除术是可行且安全的。
