腹腔镜下左半肝切除术，术前进行血管控制。
Laparoscopic left hepatectomy with prior vascular control.
机构信息
Department of General Surgery, Antoine Béclère Hospital, AP-HP, 92140 Clamart, France.
出版信息
Surg Endosc. 2010 Mar;24(3):697-9. doi: 10.1007/s00464-009-0613-1. Epub 2009 Jul 25.
BACKGROUND
Laparoscopic major resections remain a challenge for liver surgeons. This video illustrates, step by step, our laparoscopic technique for left hepatectomy.
METHODS
The control of vascular inflow and outflow as well as the division of the left hepatic duct were carried out extraparenchymally before liver transection. Between 2002 and 2008, 11 left hepatectomies were performed by laparoscopy: 7 for liver tumor and 4 for localized Caroli's disease.
RESULTS
Mean duration of surgery was 248 +/- 25 min. Mean operative blood loss was 129 +/- 42 ml. Intraoperative blood transfusion or conversion to laparotomy were never required. One postoperative biliary collection occurred and was drained percutaneously. None of the patients died. Mean hospital stay was 7.6 +/- 2.2 days.
CONCLUSIONS
This technique has proved to be safe and easily reproducible.
背景
腹腔镜下的大切除术仍然是肝脏外科医生面临的挑战。本视频逐步演示了我们的腹腔镜左半肝切除术技术。
方法
在进行肝实质切开之前，采用肝外入路控制肝门血管的流入和流出，并进行左肝管的分离。2002 年至 2008 年间，我们通过腹腔镜完成了 11 例左半肝切除术：7 例用于肝脏肿瘤，4 例用于局限性肝内胆管扩张症。
结果
手术平均时间为 248 +/- 25 分钟。平均术中出血量为 129 +/- 42 毫升。术中无输血或中转开腹。1 例术后发生胆汁性积聚，经皮引流。无患者死亡。平均住院时间为 7.6 +/- 2.2 天。
结论
该技术已被证明是安全且易于复制的。
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