摘要
目的 探讨Laennec入路肝蒂分离在解剖性肝切除术中的临床应用效果。方法 回顾性分析2020年1月至2022年9月我院肝胆外科收治的的21例行Laennec入路肝蒂分离解剖性肝切除术患者的临床资料,观察及分析手术时间、肝蒂分离时间、术中出血量、术中输血率;术后进食时间、引流管拔除时间、术后并发症发生率、术后肝功能恢复、术后住院时间、术后病理类型。结果 所有患者均顺利完成了Laennec入路肝蒂分离解剖性肝切除,腹腔镜17例,开腹4例,其中左半肝12例、左外叶2例、右半肝4例、右前叶2例、右后叶1例。手术时间(292.76±75.24)min,肝蒂分离时间(27.48±7.65)min,术中出血量(173.81±68.23)ml。术后第1天开始流质饮食、下床活动,术后第3天开始视情况拔除腹腔引流管,平均拔除腹腔引流管时间为(4.12±1.26)天。术后住院时间(9.76±2.95)天术后肝功能较术前,均好转。有2例患者术后出现胆漏,2例出现肺部感染,经保守治疗后均痊愈出院,所有患者无肝功能衰竭,无肝断面感染,围手术期无死亡患者。结论 Laennec入路肝蒂分离在解剖性肝切除术中是安全、有效的。
Objective To explore the clinical effect of separation of hepatic pedicle via the Laennec approach in anatomical hepatectomy.Methods The clinical data of 21 patients who underwent anatomical hepatectomy with hepatic pedicle sepa⁃ration via Laennec approach from January 2020 to September 2022 were retrospectively analyzed.The operation time,he⁃patic pedicle separation time,intraoperative blood loss,intraoperative blood transfusion rate,postoperative feeding time,drainage tube removal time,postoperative complication rate,postoperative liver function recovery,postoperative hospital stay,and postoperative pathological type were observed and analyzed.Results All patients successfully completed anatomi⁃calhepatectomy via the Laennec approach.Laparoscopic hepatectomy was performed in 17 cases and laparotomy in 4 cases.The total sample includs 12 cases of left half liver,2 cases of leftlaterallobe,4 cases of right half liver,2 cases of right ante⁃rior lobe and 1 case of right posterior lobe.The operation time was(292.76±75.24)min,the separation time of liver pedicle was(27.48±7.65)min,and the intraoperative blood loss was(173.81±68.23)ml.Liquid diet and off-bed activities were started on the first day after operation.Since the third day after operation,the abdominal drainage tube was removed ac⁃cording to the situation,and the average time of removing the abdominal drainage tube was(4.12±1.26)days.The liver func⁃tion decreasedafter(9.76±2.95)days of postoperative hospital stay.Postoperative bile leakage occurred in 2 patients,and pulmonary infection occurred in 2 patients after operation,all were cured and discharged after conservative treatment.There was no liver failure,no liver section infection,and no death during the perioperative period.Conclusions Separation of hepatic pedicle via the Laennec approach is safe and effective in anatomical hepatectomy.
作者
徐林龙
孙亭立
淦勤
XU Linlong;SUN Tingli;GAN Qin(Department of hepatobiliary surgery,The First People's Hospital of Jiujiang City,Jiujiang 332000,Jiangxi,China)
出处
《现代诊断与治疗》
CAS
2022年第23期3481-3484,共4页
Modern Diagnosis and Treatment
基金
江西省卫生健康委科技计划项目(202211841)。
关键词
Laennec膜
肝切除
肝蒂
手术入路
Laennec’s capsule
Hepatectomy
Hepatic pedicle
Surgical approach
