摘要
目的探讨腹腔镜肝切除治疗原发局限性肝内胆管扩张的临床疗效及手术方法的可行性和优缺点。方法一共有10例原发局限性肝内胆管扩张患者接受腹腔镜下肝切除手术,其中,男性7例,女性3例;平均年龄47岁。有2名患者行肝右叶切除,4名患者行肝左叶切除,另外4名患者行肝左外叶切除。3名伴有普通胆管结石患者在术中行胆道镜取石术。结果手术平均耗时303.9min,手术平均失血量为217mL。操作者在进行腹腔镜手术中都没有采用手辅助措施,也没有患者腹腔镜手术中或者术后又执行开放性手术。接受手术的10例患者中有9例恢复良好,一名行左半肝切除患者在术后出现了粘液积聚,重新入院后采用经皮穿刺引流治疗。患者平均住院时间为5.3d,术后半年内胆囊炎没有复发。结论由具备肝胆外科和腹腔镜两个方面专业知识以及受过相关专业训练的外科医生执行的腹腔镜肝切除术是治疗原发局限性肝内胆管扩张安全有效的方法。
[ Objective ] To explore the clinical effect,feasibility,and advantages and disadvantages of laparo- scopic liver resection for localized primary intrahepatic bile duct dilatation. [Methods ] 10 laparoscopic liver resec- tions for localized IHBD, on 7 women and 3 men （mean age 47 years） were performed. Resections were 2 right hep- atectomies, 4 left hepatectomies, and 4 left lateral sectionectomies. Three patients had associated common bile duct stones that were treated through intraoperative cholangioscopy. [ Results ] The mean operative time was 303.9 min- utes. The mean blood loss was 217 mL. None of these patients required hand assistance or conversion to open surgery. One patient suffered a residual collection that was drained pereutaneously. The postoperative course was un- eventful in the other patients. The mean hospital stay was 5.3 days. No recurrence of cholangitis was observed during the follow-up six months. [ Conclusions ] The laparoscopic treatment of IHBD is safe and should be performed by experts with expertise in both hepatobiliary surgery and laparoscopy.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第11期1197-1200,共4页
China Journal of Endoscopy
