摘要
目的探讨腹腔镜肝门部胆管癌根治术的安全性和可行性。方法回顾性总结和分析2017年12月至2018年4月绵阳市中心医院收治的4例不同Bismuth分型的腹腔镜肝门部胆管癌根治术病人的术前、术中和术后情况。结果①术中情况:4例病人均成功完成手术,平均手术时间为616.2 min(480～725 min);平均术中出血量为467.5 ml(360～540 ml)。②术后情况:4例病人中1例术后发生胆汁漏,经保守治疗5 d后痊愈;术后平均住院时间为14.25 d(12～17 d);术后随访时间1～4个月,随访期间病人一般情况良好,无肿瘤复发。结论在严格选择病人的基础上,经过术前准确评估受累胆管情况,由腹腔镜技术熟练及手术经验丰富的团队开展腹腔镜肝门部胆管癌根治术可以达到R0切除,是安全、可行的,具有病人创伤小、痛苦小、康复快、并发症少、美容效果好等优点。
Objective To explore the safety and feasibility of laparoscopic resection of hilar cholangiocarcinoma.Methods A retrospective analysis was performed on the preoperative,intraoperative and postoperative conditions of 4 patients with different Bismuth types treated by laparoscopic resection of hilar cholangiocarcinoma in our hospital within the period from December 2017 to April 2018.Results Intraoperatively,4 patients all successfully completed the operation,with average operational duration of 616.2(480-725)min and average blood loss of 467.5(360-540)mL.Postoperatively,among 4 patients,one underwent bile leakage,who recovered after 5-day conservative treatment;the average duration of hospital stay was 14.25 days(12-17 days);patients were followed up for 1-4 months after operation,during which patients were in good conditions in general and no tumor recurrence occurred.Conclusion On the basis of a strict selection of patients,after an accurate assessment of the bile duct of involvement before operation,the performance of laparoscopic resection of hilar cholangiocarcinoma by a team with skilled laparoscopic techniques and rich surgical experiences could realize R0 excision.The operation was safe and feasible,and boasted advantages including small invasion,less pain,fast recovery,less complications and good cosmetic effect to the patients.
作者
罗华
匡铭
邓澜
陈熙
胡朝辉
杨培
胡俊超
曾新桃
陈孝平
Luo Hua;Kuang Ming;Deng Lan;Chen Xi;Hu Zhaohui;Yang Pei;Hu Junchao;Zeng Xintao;Chen Xiaoping(Department of Hepatobiliary Surgery,Mianyang Central Hospital,Sichuan Mianyang 621000,China;Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)
出处
《腹部外科》
2019年第1期31-34,79,共5页
Journal of Abdominal Surgery
基金
四川省绵阳市中心医院陈孝平院士工作站合作项目
