Hüscher C G, Napolitano C, Chiodini S, Recher A, Buffa P F, Lirici M M
Department of General and Thoracic Surgery, Istituto Nazionale dei Tumori, Milano, Italy.
Ann Ital Chir. 1997 Nov-Dec;68(6):791-7.
Hepatic surgery has been undergoing progressive modifications in surgical approach to liver, passing through tohraco-phrenolaparotomy to bilateral subcostal incision and current Makuuchi's. Laparoscopic liver surgery should not be considered a new surgery, but simply a new surgical approach, with difficulties but advantages too. Laparoscopic hepatic resections are feasible with low morbidity and mortality; the short and medium term results are comparable to those obtained with open surgery provided that the surgeon has a significant experience in open hepatic surgery, advanced laparoscopic surgery and the availability of all and pertinent instrumentation. The aim of this paper is to show the rationales formal of hepatic resections through the laparoscopic approach, focusing on the necessary instrumentation, the surgical technique and results.
肝脏手术在肝脏手术入路方面一直在不断改进，从经胸膈下剖腹术发展到双侧肋下切口，再到目前的幕内式切口。腹腔镜肝脏手术不应被视为一种新的手术，而仅仅是一种新的手术入路，它有困难但也有优点。腹腔镜肝切除术是可行的，发病率和死亡率较低；只要外科医生在开放性肝脏手术、高级腹腔镜手术方面有丰富经验，并且具备所有相关器械，其短期和中期结果与开放性手术相当。本文旨在通过腹腔镜入路展示肝切除术的理论依据，重点介绍所需器械、手术技术和结果。
