摘要
目的探讨腹腔镜在肝脏良恶性疾病中的应用. 方法回顾分析47例经腹腔镜下诊断及治疗的肝脏疾病的临床效果. 结果 2例肝外伤探查后中转开腹,45例在腹腔镜下完成,其中小肝癌局部切除术1例;肝癌微波固化处理2例;肝癌切检1例;肝脏纤维增生切检2例;肝硬化切检3例;6例肝癌剖腹探查术前行腹腔镜检查,其中2例明确不能切除而避免开腹手术;肝脓肿2例;肝囊肿19例,其中1例术后囊肿反复积液,经多次穿刺抽吸26天后治愈,术后随访2～8年,无复发;肝外伤11例中术后胆漏1例,17天后引流治愈. 结论腹腔镜下进行肝脏疾病的诊断及手术,视野清晰,创伤小,但在止血方面尚缺乏合适的设备及手段.
Objective To investigate the application of laparoscopy in benign or malignant liver diseases. Methods Clinical outcomes of 47 cases of liver diseases diagnosed and treated under laparoscope were retrospectively reviewed. Results Laparoscopic explorations were converted into open operations in 2 cases of hepatic injuries, while operations were laparoscopically completed in the remaining 45 cases. Laparoscopic operations included 1 case of local excision for microhepatocarcinoma, 2 cases of microwave coagulation for hepatocarcinoma, 1 case of biopsy for hepatocarcinoma, 2 cases of biopsy for hepatic fibrosis hyperplasia, 3 cases of biopsy for hepatic cirrhosis, 6 cases of exploration for hepatocarcinoma (2 of which were found inoperable and the further open surgery was avoided), 2 cases of management for liver abscess, 19 cases of management for hepatic cyst (repeated postoperative hydrops occurred in 1 case, which was cured by multiple punctures and aspirations 26 days later, and follow-up for 2~8 years found no recurrence), and 11 cases of treatment for liver injuries (1 of which suffered postoperative bile leakage and was cured by drainage 17 days later). Conclusions Laparoscopic diagnosis and treatment for liver diseases offers clear visualization and minimal invasion. However, insufficiency in devices and methods to stop bleeding under laparoscope remains a problem.
出处
《中国微创外科杂志》
CSCD
2005年第2期138-139,141,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜
肝脏疾病
诊治
Laparoscopy
Liver disease
Diagnosis and treatment
