腹腔镜肝切除治疗肝血管瘤的临床分析

【摘要】〓目的〓探讨腹腔镜肝切除治疗肝血管瘤的可行性和疗效。方法〓回顾性分析2011年1月1日至2012年12月31日中山大学孙逸仙纪念医院肝胆外科实施的18例腹腔镜肝切除术治疗肝血管瘤病例的临床资料。结果〓18例患者均应用腹腔镜完成手术。肝血管瘤平均直径为7.6(5.5~14)cm,手术时间为(121±44)min。13例患者术中选择性半肝阻断,术中平均出血量283(60~900)mL,术后平均住院时间8(6~12)d。术后病理均证实为海绵状血管瘤。术后1例患者并发胸腔积液,经保守治疗痊愈。 结论〓选择合适的病例,掌握半肝血流阻断技术,选择正确的肝实质离断平面,合理应用离断肝实质器械,腹腔镜肝血管瘤手术是安全可行的。

The clinical effect of laparoscopic hepatectomy on hepatic hemangioma

Objective To evaluate the feasibility and efficacy of laparoscopic hepatectomy of hepatic hemangioma. Methods Clinical data of 18 patients with hepatic hemangioma who underwent laparoscopic liver resection in Department of Hepatobiliary Surgery, the Sun Yat-sen Memorial Hospital from January 2011 to December 2012 were analyzed retrospectively. Results Laparoscopic hepatectomy of hepatic hemangioma was successfully performed in 18 patients. The mean diameter of hemangioma was 7.6（5.5-14） cm, the operating time was（121 ±44） min. Thirteen patients underwent selective inflow controlled, mean blood loss was 283（60-900） ml, and mean postoperative hospital stay was 8（6-12）.d. Postoperative pathological examination showed cavernous hemangioma. Postoperative pleural effusion occurred in one patient, and was cured by conservative surgery. Conclusion Laparoscopic hepatectomy of hepatic hemangioma is safe and feasible for selective patients when half-Pringle maneuver and parenchymal transection devices are used appropriately.