摘要
目的:探讨腹腔镜保留肝右静脉(RHV)的Ⅷ背侧段属支(V8d)联合RHV切除的原位肝右后叶切除术的可行性。方法:回顾分析2019年1月至2020年10月收治的10例肝右后叶肿瘤患者的临床资料,其中男8例,女2例;40~58岁,平均(51.4±6.1)岁,术前均诊断为原发性肝癌。采用腹腔镜下保留V8d联合RHV切除的原位肝右后叶切除术,分析手术时间、术中出血量、术后住院时间、并发症、肝功能等指标。结果:10例手术均获成功,无一例中转开腹。手术时间150~240 min,平均(198.0±30.8)min;术中出血量100~700 mL,平均(345.0±216.6)mL。术后未发生出血、肝功能衰竭、胆漏、感染、死亡等严重并发症。术后病理均为肝细胞癌,手术切缘阴性。术后住院7~14 d,平均(9.5±2.2)d。结论:腹腔镜下保留V8d联合RHV切除的原位肝右后叶切除术治疗肝肿瘤行是安全、可行的。
Objective:To investigate the feasibility of laparoscopic extended right posterior lobectomy in situ combined with resection of right hepatic vein(RHV)and preservation of dorsal branch of segmentⅧ(V8d).Methods:Clinical data of 10 patients who suffered from hepatic tumors located in the right posterior lobe from Jan.2019 to Oct.2020 were retrospectively analyzed.Ten patients included 8 males and 2 females,aged 40-58 years,the average age was(51.4±6.1)years,they were diagnosed with primary liver cancer preoperatively.They underwent laparoscopic extended right posterior lobectomy combined with resection of RHV and preservation of V8d in situ.The clinical data were analyzed,including operative time,intraoperative blood loss,postoperative hospital stay,complications and liver function.Results:All 10 operations were successful,none was converted to laparotomy.The operative time was 150 to 240 min,and the average time was(198.0±30.8)min.The blood loss was 100 to 700 mL,and the average was(345.0±216.6)mL.No one was diagnosed with hemorrhage,liver failure,bile leakage,infection,death or other serious complications postoperatively.The postoperative pathology in 10 cases was hepatocellular carcinoma,all had negative surgical margins.The postoperative hospital stay was 7-14 d with the average of(9.5±2.2)d.Conclusions:Laparoscopic extended right posterior lobectomy in situ combined with resection of RHV and preservation of V8d is safe and feasible in the treatment of liver neoplasms.
作者
郑志鹏
陈雪芳
叶青
彭建新
刁竞芳
何军明
ZHENG Zhi-peng;CHEN Xue-fang;YE Qing(Department of Hepatobiliary Surgery,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,China)
出处
《腹腔镜外科杂志》
2021年第9期651-653,657,共4页
Journal of Laparoscopic Surgery
基金
广东省科技计划项目(2017ZC0193)。
关键词
肝肿瘤
肝切除术
腹腔镜检查
肝右静脉
Liver neoplasms
Hepatectomy
Laparoscopy
Right hepatic vein
