腹腔镜肝尾状叶巨大血管瘤切除的临床体会

目的探讨腹腔镜肝尾状叶巨大血管瘤切除的手术技巧。 方法回顾性分析2016年5月至2019年5月在南昌大学第二附属医院肝胆外科行腹腔镜肝尾状叶巨大血管瘤切除术患者的临床资料，采用SPSS20.0统计学软件计算患者的瘤体大小、术中出血量、手术时间及术后住院时间的平均值，患者出院后每隔6个月复查腹部彩超的方式了解患者肝脏情况。 结果所有患者均成功完成腹腔镜肝尾状叶巨大血管瘤切除术，瘤体大小10～15 cm，平均(12±2)cm；术中出血量60～160 ml，平均(99±34)ml；手术时间160～250 min，平均(201±29)min；术后住院时间7～13 d，平均9 d；术后患者均出现短暂性的ALT、AST升高，给予护肝治疗后较快恢复，无出血、胆瘘、肝功能衰竭等严重并发症发生，术后所有患者均存活且无复发，仍在随访中。 结论术前对患者一般情况的充分评估，术中的耐心、精细、精准的脉管处理，以及术野良好的显露等是腹腔镜肝尾状叶巨大血管瘤切除术成功实施的保障。

The laparoscopic surgical experience of giant hemangioma of the caudate lobe of the liver

ObjectiveTo explore the laparoscopic surgical experience of giant hemangioma of the caudate lobe of the liver. MethodsThe clinical information of patients with giant hemangioma of the caudate lobe of the liver who underwent laparoscopic resection in The Second Affiliated Hospital of Nanchang University from May 2016 to May 2019 were retrospectively analyzed.SPSS20. 0 statistical software was used to calculate the average value of the tumor size, intraoperative blood loss, operation time, etc.The patients were followed up by abdominal ultrasonography to understand the liver condition. ResultsAll patients completed laparoscopic hepatic caudate lobectomy successfully.The tumor size was 10-15 cm, with an average of (12±2)cm.The intraoperative blood loss was 60-160 ml, with an average of(99 ± 34) ml.The operation time was 160-250 minutes, with an average of ( 201±29 ) minutes.The duration of hospital day was 7-13 days, with an average of 9 days.Postoperative patients showed alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher compared with the baseline levels in the first few days, and recovered quickly after liver protection treatment.No serious complications such as hemorrhage, biliary fistula and liver failure occurred.All patients survived without recurrence and still during follow-up. ConclusionsAdequate assessment of the patient′s general condition before surgery, careful operative and good exposure during the operation are the basis for laparoscopic hepatic caudate lobectomy.