Chen Huan Wei, Deng Fei Wen, Hu Jian Yuan, Li Jie Yuan, Lai Eric Chun Hung, Lau Wan Yee
Department of Liver Surgery, The First People's Hospital of Foshan, Foshan, Guang Dong, The People's Republic of China.
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan.
Surg Laparosc Endosc Percutan Tech. 2017 Dec;27(6):e145-e148. doi: 10.1097/SLE.0000000000000483.
Laparoscopic liver resection under hemihepatic vascular inflow control has advantages over Pringle's maneuver, especially in patients with cirrhosis. From January 2016 to August 2016, 7 patients who underwent total laparoscopic left hepatectomy under hemihepatic vascular inflow occlusion using the extra-glissonian approach were included in this study. All were hepatitis B carriers and 4 had cirrhosis. The mean operation time was 247 minutes. The mean transection time was 110 minutes. No patient needed additional Pringle's maneuver. The mean intraoperative blood loss was 74 ml and no patient required blood transfusion. No open conversion happened. Postoperatively, no patient developed complications and there was no perioperative mortality. The mean resection margin was 2 cm. The mean hospital stay was 6 days. Upon a mean follow-up of 9 months, no patient developed tumor recurrence. The technique of total laparoscopic left hepatectomy using extra-glissonian approach was safe and feasible. The early surgical outcomes were good.
半肝血流控制下的腹腔镜肝切除术相较于普林格尔手法具有优势，尤其是在肝硬化患者中。2016年1月至2016年8月，本研究纳入了7例采用肝外Glisson鞘入路行半肝血流阻断下全腹腔镜左肝切除术的患者。所有患者均为乙肝携带者，其中4例有肝硬化。平均手术时间为247分钟。平均肝断面处理时间为110分钟。无患者需要额外的普林格尔手法。平均术中出血量为74毫升，无患者需要输血。无中转开腹情况发生。术后，无患者出现并发症，无围手术期死亡。平均切缘为2厘米。平均住院时间为6天。平均随访9个月时，无患者出现肿瘤复发。采用肝外Glisson鞘入路行全腹腔镜左肝切除术的技术安全可行。早期手术效果良好。
