摘要
目的介绍小切口肝切除的应用方法与体会。方法2006年1月至2007年1月,23例患者行小切口肝切除,其中男15例,女8例,年龄21～63岁,平均(46.28±7.25)岁。术前肝功能Child-Pugh分级A级18例,B级5例。手术采用右侧肋缘下小切口入腹,应用拉钩暴露术野,采用Biclamp和Ligasure离断肝脏。结果23例患者均在预定小切口下完成手术,切口长度6～11(8.20±1.12)cm,手术时间(158.67±47.71)min,出血量50～400ml,平均(389.52±201.43)ml,术中未发生不能控制的出血。术后平均住院日为(6.81±1.89)d。腹水1例,经保守治疗控制。无其他并发症及死亡。结论对于特定的病例,经过术前影像学评估和设计,采用小切口进行肝切除,可以减少手术创伤和并发症。
Objective To introduce the methods and experience of mini -incision hepatectomy. Methods During Jan. 2006 to Jan. 2007,23 cases were cured by mini - incision bepatectomy, including 15 men and 8 women with the age of 46.28 ± 7.25 years old （range： 21 -63 ）. Eighteen cases were categoried into＂ Class A＂of Child- Pugh classification and 5 cases＂ Class B＂. By an approach to the abdominal cavity through right subeostal incision, a retractor was used to expose operating field, and Biclamp and Ligasure to transect liver parenchyma. Results The operation was successfully done via mini- incision hepatectomy in all the 23 cases. The incision length was （8.20±1.12） cm （rang： 6 - 11 ）, the operative time was （ 158.67 ± 47.71 ） min, the blood loss was （ 389.52 ± 201.43 ） ml （ range ： 50 - 400 ）. No uncontrollable bleeding occurred during operation. The postoperative hospital stay was （6.81 ± 1.89） days, ascites occurred in 1 case cured by conservative treatment. Conclusion In selected patients ,throught pre -operation imaging evaluating and designing, hepatectomy can be completed via mini - incision which could reduce surgical trauma and the occurrence of complications.
出处
《临床外科杂志》
2008年第2期108-110,共3页
Journal of Clinical Surgery
关键词
肝切除
小切口手术
微创手术
hepatectomy
mini - incision surgery
minimally invasive surgery
