摘要
目的:探讨保留肝圆韧带的三孔法腹腔镜肝左外叶切除术的临床应用价值。方法:回顾分析2016年1月至2018年12月为52例患者行腹腔镜肝左外叶切除术的临床资料,其中30例采用三孔法(三孔组)、22例采用传统四孔法(四孔组)施术,分析两组手术时间、术中出血量、术后下床活动时间、排气时间、术后并发症、术后住院时间等指标。结果:52例均顺利完成腹腔镜肝左外叶切除术,三孔法与四孔法相比,术中出血量[(44.17±8.09)mL vs.(54.29±9.78)mL]、手术时间[(56.11±8.90)min vs.(66.07±8.03)min]、肠功能恢复时间(以自主肛门排气为标准)[(21.44±5.93)h]vs.(28.57±6.75)h]、住院时间[(6.39±1.50)d vs.(8.14±1.75)d]差异有统计学意义(P<0.05),下床活动时间[(16.00±2.95)h vs.(17.79±2.75)h]差异无统计学意义(P>0.05);三孔组住院期间发生胆漏1例,四孔组发生肺部感染1例,均经对症治疗后痊愈,术后并发症发生率(3.33%vs.4.55%)差异无统计学意义(P>0.05)。结论:保留肝圆韧带的三孔法腹腔镜肝左外叶切除术较传统四孔法手术时间短、创伤小、康复快,在简单肝切除的基础上便于开展,适合临床推广。
Objective:To investigate the clinical value of three-port laparoscopic left lateral hepatectomy with preservation of ligamentum teres hepatis.Methods:The clinical data of 52 patients with laparoscopic left lateral lobe resection from Jan.2016 to Dec.2018 were retrospectively analyzed,including 30 cases of three-port method and 22 cases of traditional four-port method.The operation time,intraoperative blood loss,postoperative ambulation time,exhaust time,postoperative complications,postoperative hospital stay were analyzed.Results:Laparoscopic left lateral lobectomy was performed successfully in all 52 patients.Intraoperative blood loss[(44.17±8.09)mL vs.(54.29±9.78)mL],operation time[(56.11±8.90)min vs.(66.07±8.03)min],intestinal function recovery time(based on the standard of spontaneous anal exhaust)[(21.44±5.93)h vs.(28.57±6.75)h]and the hospitalization time[(6.39±1.50)d vs.(8.14±1.75)d]had statistically significant difference between the three-port method and the four-port method(P<0.05).There was no significant difference in postoperative ambulation time[(16.00±2.95)h vs.(17.79±2.75)h,P>0.05].There was 1 case of bile leakage in the three-port group and 1 case of pulmonary infection in the four-port group,which were cured after symptomatic treatment,and the incidence of postoperative complications(3.33%vs.4.55%)was not statistically significantly different(P>0.05).Conclusions:Compared with the traditional four-port method,the three-port laparoscopic left lateral lobectomy with preservation of the ligamentum teres hepatis has the advantages of shorter operation time,less surgical trauma and faster recovery.It is easy to carry out on the basis of simple hepatectomy and is suitable for clinical promotion.
作者
秦贯军
刘明明
崔虎啸
侯森
QIN Guan-jun;LIU Ming-ming;CUI Hu-xiao(Department of Hepatobiliary Surgery,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China)
出处
《腹腔镜外科杂志》
2020年第12期928-931,共4页
Journal of Laparoscopic Surgery
关键词
肝左外叶切除术
肝圆韧带
腹腔镜检查
三孔
Hepatic left lateral lobectomy
Ligamentum teres hepatis
Laparoscopy
Three-port
