Stanek Maciej, Pędziwiatr Michał, Radkowiak Dorota, Zychowicz Anna, Budzyński Piotr, Major Piotr, Budzyński Andrzej
Pol Przegl Chir. 2016 Jan 1;88(1):20-5. doi: 10.1515/pjs-2016-0022.
The aim of the study was to present early outcomes of liver resection using laparoscopic technique.
Retrospective analysis of patients who underwent liver resection using laparoscopic method was conducted. The analyzed group included 23 patients (11 women and 12 men). An average patient age was 61.3 years (37 - 83 years). Metastases of the colorectal cancer to the liver were the cause for qualification to the procedure of 15 patients, metastasis of breast cancer in 1 patient and primary liver malignancy in 5 patients. The other 2 patients were qualified to the liver resection to widen the surgical margins due to gall-bladder cancer diagnosed in the pathological assessment of the specimen resected during laparoscopic cholecystectomy, initially performed for other than oncology indications.
Hemihepatectomy was performed in 11 patients (9 right and 2 left), while the other 12 patients underwent minor resection procedures (5 metastasectomies, 4 nonanatomical liver resections, 1 bisegmentectomy, 2 resections of the gall-bladder fossa). An average duration of the surgical procedure was 275 minutes 65 - 600). An average size of the resected tumors was 28 mm (7 - 55 mm). In three cases conversion to laparotomy occurred, caused by excessive bleeding from the liver parenchyma. Postoperative complications were found in 4 patients (17.4%). Median hospitalization duration was 6 days (2 - 130 days). One patient (4.3%) was rehospitalized due to subhepatic abscess and required reoperation. Histopathology assessment confirmed radical resection (R0) in all patients in our group.
Laparoscopic liver resections seem to be an interesting alternative in the treatment of focal lesions in the liver.
本研究的目的是展示使用腹腔镜技术进行肝切除的早期结果。
对采用腹腔镜方法进行肝切除的患者进行回顾性分析。分析组包括23例患者（11名女性和12名男性）。患者平均年龄为61.3岁（37 - 83岁）。15例患者因结直肠癌肝转移而符合手术条件，1例因乳腺癌转移，5例因原发性肝恶性肿瘤。另外2例患者因在最初因非肿瘤适应症进行的腹腔镜胆囊切除术中切除标本的病理评估中诊断为胆囊癌，为扩大手术切缘而符合肝切除条件。
11例患者进行了半肝切除（9例右半肝切除和2例左半肝切除），另外12例患者进行了小范围切除手术（5例肝转移瘤切除、4例非解剖性肝切除、1例双段切除、2例胆囊窝切除）。手术平均时长为275分钟（65 - 600分钟）。切除肿瘤的平均大小为28毫米（7 - 55毫米）。3例因肝实质出血过多转为开腹手术。4例患者（17.4%）出现术后并发症。中位住院时长为6天（2 - 130天）。1例患者（4.3%）因肝下脓肿再次入院并需要再次手术。组织病理学评估证实我们组所有患者均为根治性切除（R0）。
腹腔镜肝切除似乎是治疗肝脏局灶性病变的一种有趣的替代方法。
