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目的探讨腹腔镜肝切除治疗肝血管瘤的可行性。方法 2002年1月至2006年10月共治疗18例肝血管瘤患者,应用腹腔镜下肝门阻断器阻断第一肝门的血流后,使用电刀、超声刀等方法断肝,肝断面采用腹腔镜下肝针缝合并喷洒生物蛋白胶等方法处理,行腹腔镜肝段或局部切除10例、行左肝外叶切除术5例、行规则性左半肝切除术2例、行不规则性左半肝切除术1例;其中合并胆囊切除2例、合并阑尾切除1例。结果 18例患者手术均获得成功,手术时间(185.4±55.7)min;术中出血(416.2±128.8)ml;术后恢复顺利,无严重并发症,患者住院时间(6.2±1.0)d。结论腹腔镜肝切除治疗肝血管瘤安全、可行。
Objective To investigate the feasibility of laparoscopic hepatectomy for the treatment of hepatic hemangiomas. Methods From January 2002 to October 2006, a total of 18 patients with hepatic hemangioma were treated. Laparoscopic hepatic portal blockade was used to block the blood flow of the first hepatic portal and the liver was severed by electric knife and ultrasonic knife. The liver section was treated by laparoscopic hepatic stitching and spraying with bio-protein glue. 10 cases underwent laparoscopic segmentectomy or local excision, 5 cases underwent left hepatic resection and 2 cases underwent regular left hepatectomy. 1 case of irregular left hepatectomy; 2 cases with cholecystectomy and 1 case with appendectomy. Results Eighteen patients underwent surgery successfully. The operation time was (185.4 ± 55.7) min. The intraoperative bleeding was (416.2 ± 128.8) ml. The postoperative recovery was smooth and no serious complications were found. The length of hospital stay was (6.2 ± 1.0) days. Conclusions Laparoscopic hepatectomy is safe and feasible for the treatment of hepatic hemangiomas.