Yoon Yoo-Seok, Han Ho-Seong, Cho Jai Young, Ahn Keun Soo
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Korea.
J Laparoendosc Adv Surg Tech A. 2009 Oct;19(5):653-6. doi: 10.1089/lap.2009.0012.
A central bisectionectomy of the liver removes segments 4, 5, and 8, and this is a technically demanding operation because it requires two transection planes. Until now, the laparoscopic approach for this operative procedure has been rarely attempted. We report in this article on a totally laparoscopic central bisectionectomy that was performed in a 49-year-old male who had centrally located hepatocellular carcinoma (HCC), and this tumor was in contact with the middle hepatic vein. The operative procedure was performed by using five trocars with the patient placed in the lithotomy position. The operative time was 430 minutes, the estimated blood loss was about 800 mL, and no perioperative transfusion was needed. The postoperative pathology confirmed a HCC with a 1-cm free resection margin. The patient was discharged on postoperative day 13 without any significant complications. This case shows the feasibility and safety of performing the totally laparoscopic central bisectionectomy for resecting HCC.
肝脏中央二分切除术切除第4、5和8段，这是一项技术要求很高的手术，因为它需要两个切除平面。到目前为止，很少有人尝试这种手术的腹腔镜方法。我们在本文中报告了一例在一名49岁男性患者中进行的完全腹腔镜中央二分切除术，该患者患有位于中央的肝细胞癌（HCC），且该肿瘤与肝中静脉相连。手术通过使用五个套管针进行，患者处于截石位。手术时间为430分钟，估计失血量约800毫升，无需围手术期输血。术后病理证实为HCC，切缘阴性1厘米。患者于术后第13天出院，无任何严重并发症。该病例显示了完全腹腔镜中央二分切除术切除HCC的可行性和安全性。
