目的:探讨Belghiti悬挂法在解剖性半肝切除术中的应用价值.方法:Belghiti肝脏悬挂法成功行半肝切除术患者28例,并与未采用Belghiti肝脏悬挂法完成的解剖性半肝切除术患者22例比较,分析评价患者术中相关指标和术后并发症.结果:2组患者均...目的:探讨Belghiti悬挂法在解剖性半肝切除术中的应用价值.方法:Belghiti肝脏悬挂法成功行半肝切除术患者28例,并与未采用Belghiti肝脏悬挂法完成的解剖性半肝切除术患者22例比较,分析评价患者术中相关指标和术后并发症.结果:2组患者均无手术死亡,Belghiti悬挂组的术中失血量和输血量均较对照组显著减少(426.36±312.79mL vs 526.58±251.32mL;508.13±128.26mL vs 735.13±216.79mL,均P<0.05).2组的术后肝功能、并发症发生率、住院时间无显著差异.结论:Belghiti悬挂法可进一步提高半肝切除的安全性,减少出血,并且可在先不游离肝脏的情况下完成半肝切除,更符合肿瘤外科的基本原则.展开更多
Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far ...Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far no report has detailed how to quickly and easily establish RT for laparoscopic LHM in LRH, nor has employment of the Goldfinger dissector to create a total RT been reported. This study＇s aim was to evaluate the safety and feasibility of establishing RT for laparoscopic LHM using the Goldfinger dissector in LRH. Methods： Between March 2015 and July 2015, five consecutive patients underwent LRH via the caudal approach with laparoscopic LHM. A five-step strategy using the Goldfinger dissector to establish RT for laparoscopic LHM was adopted. Perioperative data were analyzed. Results： The median age of patients was 58 （range, 51-65） years. Surgery was performed for one intrahepatic lithiasis and four hepatocellular carcinomas with a median size of 90 （40-150） mm. The median operative time was 320 （282-358） min with a median blood loss of 200 （200-600） ml. Laparoscopic LHM was achieved in a median of 31 （21-62） min, and the median postoperative hospital stay was 14 （9-16） d. No transfusion or conversion was required, and no severe liver-related morbidity or death was observed. Conclusions： The Goldfinger dissector is a useful instrument for the establishment of RT. A five-step strategy using the Goldfinger dissector can quickly and easily facilitate an RT for a laparoscopic LHM in LRH.展开更多
文摘目的:探讨Belghiti悬挂法在解剖性半肝切除术中的应用价值.方法:Belghiti肝脏悬挂法成功行半肝切除术患者28例,并与未采用Belghiti肝脏悬挂法完成的解剖性半肝切除术患者22例比较,分析评价患者术中相关指标和术后并发症.结果:2组患者均无手术死亡,Belghiti悬挂组的术中失血量和输血量均较对照组显著减少(426.36±312.79mL vs 526.58±251.32mL;508.13±128.26mL vs 735.13±216.79mL,均P<0.05).2组的术后肝功能、并发症发生率、住院时间无显著差异.结论:Belghiti悬挂法可进一步提高半肝切除的安全性,减少出血,并且可在先不游离肝脏的情况下完成半肝切除,更符合肿瘤外科的基本原则.
基金Project supported by the General Research Project of Medicine and Science of Zhejiang Province(Nos.2014KYB119 and 2015KYB221),China
文摘Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far no report has detailed how to quickly and easily establish RT for laparoscopic LHM in LRH, nor has employment of the Goldfinger dissector to create a total RT been reported. This study＇s aim was to evaluate the safety and feasibility of establishing RT for laparoscopic LHM using the Goldfinger dissector in LRH. Methods： Between March 2015 and July 2015, five consecutive patients underwent LRH via the caudal approach with laparoscopic LHM. A five-step strategy using the Goldfinger dissector to establish RT for laparoscopic LHM was adopted. Perioperative data were analyzed. Results： The median age of patients was 58 （range, 51-65） years. Surgery was performed for one intrahepatic lithiasis and four hepatocellular carcinomas with a median size of 90 （40-150） mm. The median operative time was 320 （282-358） min with a median blood loss of 200 （200-600） ml. Laparoscopic LHM was achieved in a median of 31 （21-62） min, and the median postoperative hospital stay was 14 （9-16） d. No transfusion or conversion was required, and no severe liver-related morbidity or death was observed. Conclusions： The Goldfinger dissector is a useful instrument for the establishment of RT. A five-step strategy using the Goldfinger dissector can quickly and easily facilitate an RT for a laparoscopic LHM in LRH.
