经前入路腹腔镜右半肝切除术治疗肝细胞癌
Laparoscopic Right Hepatectomy Via an Anterior Approach for Hepatocellular Carcinoma.
作者信息
Chen Huan Wei, Deng Fei Wen, Wang Feng Jie, Li Jie Yuan, Lai Eric C H, Lau Wan Yee
机构信息
Department of Liver Surgery, The First People's Hospital of Foshan, Guang Dong, The People's Republic of China.
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, The People's Republic of China.
出版信息
JSLS. 2018 Jan-Mar;22(1). doi: 10.4293/JSLS.2017.00084.
BACKGROUND AND OBJECTIVES
In the past, right hepatectomy via the anterior approach has been regarded as one of the many standard approaches for hepatectomy. However, total laparoscopic right hepatectomy from the anterior approach has been regarded as technically challenging. We report our experience in using the anterior approach in total laparoscopic right hepatectomy for hepatocellular carcinoma (HCC).
METHODS
From June 2013 through December 2015, five consecutive patients underwent total laparoscopic right hepatectomy using the anterior approach, but without the hanging maneuver.
RESULTS
The mean operative time was 360 (range, 300-480) minutes, and the mean blood loss was 340 (110-600) mL. No patient needed any blood transfusion. There was no conversion to open surgery. Ascites, pleural effusion, and bile leakage occurred in 2, 1, and 1 patients, respectively. No patients expired as a result of the surgery or liver failure. The mean hospital stay was 7 (4-15) days. All patients had R0 resection. After a mean follow-up of 22 (8-33) months, no patients experienced recurrence of disease.
CONCLUSION
Total laparoscopic right hepatectomy using the anterior approach is feasible and safe.
背景与目的
过去，经前入路的右肝切除术一直被视为肝切除术的多种标准入路之一。然而，经前入路的完全腹腔镜下右肝切除术在技术上一直被认为具有挑战性。我们报告我们在完全腹腔镜下经前入路行肝细胞癌（HCC）右肝切除术的经验。
方法
2013年6月至2015年12月，连续5例患者接受了经前入路的完全腹腔镜下右肝切除术，但未采用悬吊技术。
结果
平均手术时间为360（范围300 - 480）分钟，平均失血量为340（110 - 600）毫升。无患者需要输血。无中转开腹手术情况。分别有2例、1例和1例患者出现腹水、胸腔积液和胆漏。无患者因手术或肝功能衰竭死亡。平均住院时间为7（4 - 15）天。所有患者均实现R0切除。平均随访22（8 - 33）个月后，无患者出现疾病复发。
结论
经前入路的完全腹腔镜下右肝切除术是可行且安全的。
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