Rau H G, Buttler E, Meyer G, Schardey H M, Schildberg F W
Department of Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany.
Hepatogastroenterology. 1998 Nov-Dec;45(24):2333-8.
BACKGROUND/AIMS: Tumor size and location are the major influences on the practicality of a laparoscopic operation. Visual control of the operating field is important for isolation and ligation of blood vessels and bile ducts after selective liver dissection by suitable techniques such as the water-jet dissector.
We carried out laparoscopic liver resections with the Jet-Cutter in 17 patients. The results were compared to a control group of 17 closely matched patients undergoing conventional hepatic resection during the period of the study. In 1 patient, conversion of laparoscopic to an open operation was required.
Early in our learning curve, the duration of operation and time for resection were significantly longer in the laparoscopic group. Following laparoscopic operation, patients were discharged from the hospital after a mean of 7.8+/-8.2 days; patients having undergone conventional operation were discharged after a mean of 11.6+/-12.8 days.
Laparoscopic liver resection is technically feasible, but, at present, careful patient selection is required.
背景/目的:肿瘤大小和位置是影响腹腔镜手术可行性的主要因素。在通过诸如水刀分离器等合适技术进行选择性肝切除术后,对手术视野的视觉控制对于血管和胆管的分离及结扎很重要。
我们对17例患者实施了使用喷射切割器的腹腔镜肝切除术。将结果与研究期间17例接受传统肝切除术的匹配良好的对照组患者进行比较。有1例患者需要将腹腔镜手术转为开腹手术。
在我们学习曲线的早期,腹腔镜组的手术时间和切除时间明显更长。腹腔镜手术后,患者平均7.8±8.2天出院;接受传统手术的患者平均11.6±12.8天出院。
腹腔镜肝切除术在技术上是可行的,但目前需要仔细选择患者。