腹腔镜右后叶切除术：单中心经验及技术要点
Laparoscopic right posterior sectionectomy: single-center experience and technical aspects.
作者信息
D'Hondt Mathieu, Ovaere Sander, Knol Joep, Vandeputte Mathieu, Parmentier Isabelle, De Meyere Celine, Vansteenkiste Franky, Besselink Marc, Pottel Hans, Verslype Chris
机构信息
Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium.
Department of Abdominal Surgery, Jessa Hospital, Salvatorstraat 20, 3500, Hasselt, Belgium.
出版信息
Langenbecks Arch Surg. 2019 Feb;404(1):21-29. doi: 10.1007/s00423-018-1731-9. Epub 2018 Nov 21.
PURPOSE
Laparoscopic right posterior sectionectomy (LRPS) is a technically demanding procedure. The aim of this article is to share our experience with LRPS and to highlight technical aspects of this procedure.
METHODS
This is a single-center retrospective analysis of all patients who underwent LRPS between September 2011 and October 2017. Data were retrieved from a prospectively maintained database. Video-in-picture (VIP) technology is used to facilitate and to highlight the technical aspects of this procedure.
RESULTS
In total, 18 patients underwent LRPS. Indication for surgery was mainly liver metastases (n = 11) and hepatocellular carcinoma (n = 6). The Glissonean approach for inflow control was used in 13 patients. Median operative time was 162 (140-190) minutes. Median blood loss was 325 mL (IQR: 150-450). One conversion (5.5%) was required. There were two minor complications and one major complication. Median hospital stay was 6 days (range 5-8 days). All patients had an R0 resection. There was no 90-day mortality.
CONCLUSION
The results of our experience in LRPS add weight to the feasibility and safety of this approach.
目的
腹腔镜右后叶切除术（LRPS）是一项技术要求较高的手术。本文旨在分享我们开展LRPS的经验，并强调该手术的技术要点。
方法
这是一项对2011年9月至2017年10月期间所有接受LRPS患者的单中心回顾性分析。数据来自前瞻性维护的数据库。采用画中画（VIP）技术来辅助并突出该手术的技术要点。
结果
共有18例患者接受了LRPS。手术指征主要为肝转移瘤（n = 11）和肝细胞癌（n = 6）。13例患者采用Glissonean入路进行血流控制。中位手术时间为162（140 - 190）分钟。中位失血量为325 mL（四分位间距：150 - 450）。需要1例中转手术（5.5%）。发生了2例 minor并发症和1例major并发症。中位住院时间为6天（范围5 - 8天）。所有患者均实现了R0切除。无90天内死亡病例。
结论
我们开展LRPS的经验结果进一步证明了该手术方法的可行性和安全性。
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