摘要
目的分析腹腔镜肝血管瘤剥除术在临床应用中的可行性和安全性,提出腹腔镜肝血管瘤剥除术的技术规范。方法回顾性分析2015年11月至2019年2月在河北医科大学第二医院肝胆外科行腹腔镜肝血管瘤剥除术的82例临床资料。结果82例手术均顺利完成,无中转开腹,无术后出血、胆瘘及死亡等严重并发症的发生;手术时间(118.2±46.5)min;肝门阻断时间(30.4±16.2)min,其中肝脏2段、3段血管瘤20例,未行肝门阻断;行肝门阻断后,肝功能指标有所升高,术后5 d内肝功能恢复到术前水平;术中出血(292.1±78.1)ml;手术创面旁常规放置引流管,术后拔除引流管时间1~3 d;术后第1天下地活动,第2天进流食,住院时间(5.7±1.4)d。结论术中合理应用第一肝门阻断技术及肝脏牵拉悬吊技术,利用超声刀及双极电凝处理手术创面,腹腔镜肝血管瘤剥除术的临床应用安全、可行,值得在临床上推广。
Objective To investigate the feasibility and safety of laparoscopic enucleation of hepatic hemangioma and propose technical specification of laparoscopic enucleation of hepatic hemangioma.Methods The clinical data of 82 patients who underwent laparoscopic hepatic hemangioma stripping in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from November 2015 to February 2019 were retrospectively analyzed.Results All 82 patients underwent laparoscopic enucleation of hepatic hemangioma successfully without conversion.No postoperative hemorrhage,bile leakage and death occured.The operation duration was(118.2±46.5)min.The hepatic hilum occlusion time was(30.4±16.2)min and 20 patients with hemangioma in the liver segment 2 or 3 didn′t receive hepatic hilum occlusion.After hepatic hilum occlusion,the parameter of liver function decreased to preoperative level within 5 days.The estimated blood loss was(292.1±78.1)ml.Drainage tubes were placed under the liver remnant and were removed 1-3 days after surgery.All patients could ambulate on postoperative day 1 and have liquid diets on postoperative day 2.The average postoperative hospital stay was(5.7±1.4)days.Conclusion The first hepatic hilar occlusion and liver-hanging maneuver should be appropriately applied during the procedure,the ultrasonic scalpel and bipolar electrocoagulation were used to treat the surgical wound.The clinical application of laparoscopic hepatic hemangioma stripping was feasible and safe.It is worthy of being widely popularized in the clinical application.
作者
张树彬
王丽丽
冯峰
王乐
李昂
邢中强
刘建华
Zhang Shubin;Wang Lili;Feng Feng;Wang Le;Li Ang;Xing Zhongqiang;Liu Jianhua(Department of Hepatobiliary Surgery,Second Hospital of Hebei Medical University,Hebei Shijiazhuang 050000,China)
出处
《腹部外科》
2020年第2期136-139,共4页
Journal of Abdominal Surgery
关键词
腹腔镜
肝血管瘤
剥除术
Laparoscope
Hepatic hemangioma
Enucleation
