Department of Hepatobiliary Surgery, Southwest Hospital, First Affiliated Hospital of Army Medical University, Chongqing, China; Department of Hepatobiliary Surgery, Qinghai Provincial People's Hospital, Xining, China.
Department of Hepatobiliary Surgery, Southwest Hospital, First Affiliated Hospital of Army Medical University, Chongqing, China.
Asian J Surg. 2023 Nov;46(11):4737-4742. doi: 10.1016/j.asjsur.2023.04.002. Epub 2023 Apr 21.
To investigate the safety and feasibility of laparoscopic resection of focal nodular hyperplasia (FNH) in the hepatic caudate lobe.
The clinical data of eight patients who underwent laparoscopic hepatic caudate lobe FNH resection at the Department of Hepatobiliary Surgery, Southwest Hospital, First Affiliated Hospital of Army Medical University, were retrospectively analyzed.
The laparoscopic procedures were successful in all eight patients, and no patients required conversion to open surgery. Five patients underwent partial caudate lobe resection, one patient underwent caudate lobe resection, and two patients underwent combined left hemihepatectomy with caudate lobe resection. Tumor resection was performed using the left approach in five cases, the right approach in one case, the middle hepatic fissure approach in one case, and the left and right combined approach in one case. The operation time ranged from 120 to 360 min, with a mean of 225 min. The intraoperative blood loss ranged from 50 to 600 ml, with a mean of 235 ml. No postoperative bleeding, bile leakage or abdominal infection occurred.
Laparoscopic resection of hepatic caudate lobe FNH was safe and feasible in appropriate patients. Skilled laparoscopic hepatectomy techniques, adequate preoperative evaluation, appropriate choice of surgical approach and the control of intraoperative bleeding are critical to perform this surgery.
探讨腹腔镜下肝尾状叶局灶性结节性增生（FNH）切除术的安全性和可行性。
回顾性分析陆军军医大学第一附属医院肝胆外科 2019 年 1 月至 2022 年 6 月收治的 8 例行腹腔镜肝尾状叶 FNH 切除术患者的临床资料。
8 例患者均顺利完成腹腔镜手术，无中转开腹。5 例行部分尾状叶切除术，1 例行尾状叶切除术，2 例行左半肝联合尾状叶切除术。肿瘤切除采用左入路 5 例，右入路 1 例，中肝裂入路 1 例，左右联合入路 1 例。手术时间 120～360 min，平均 225 min；术中出血量 50～600 ml，平均 235 ml。术后无出血、胆漏及腹腔感染等并发症发生。
对于合适的患者，腹腔镜下肝尾状叶 FNH 切除术是安全可行的。熟练的腹腔镜肝切除术技术、充分的术前评估、合理的手术入路选择和术中出血的控制是完成该手术的关键。
