摘要
目的探讨腹腔镜肝切除治疗肝内胆管结石的临床经验。方法经临床筛选单纯性肝内胆管结石病例10例,应用电刀、超声刀等断肝方法,肝断面采用腔镜下用肝针缝合,并喷洒生物蛋白胶等处理方法,行腹腔镜肝切除术,其中行规则性左半肝切除术1例,不规则性左半肝切除术2例,左外叶切除7例;合并胆囊切除2例。结果10例患者手术均获得成功,手术时间(219±58.63)min;术中出血(326±120.57)mL。术后恢复顺利,除1例胆漏外,无其他并发症,病人住院(6±1.63)d,残石率0%(0/10)。结论腹腔镜肝切除治疗肝内胆管结石安全、可行,具有微创的优点,但仍有局限性,术前CT、ERCP、MRCP或PTC等检查不可少,术中控制出血是关键。此外,手术者还必须有熟练的腹腔镜技术和肝脏外科技术。
[Objective] To evaluate the feasibility of and indications for hepatolithiasis treatment using laparoscopic liver resection. [Methods] Candidate for laparoscopic liver resection were 10 cases of hepatolithiasis. Electric-cautely, uhracision were used for liver transection. Operative procedures included anatomical left hepatectomy in 1 case, non-anatomical left hepatectomy 2 cases, left lobectomy 7 cases. 2 cases of hepatolithiasis associatet with gallbladder stone were performed holecystectomy synchronously. [Results] Laparoscopic liver resection was successfully performed in all 10 cases. The operative duration was （219±58.63） rain. The quantity of blood lost during the operation was （326±120.57） mL. The postoperative recovery was smooth and good except that 1 patient had a complication of bile leakage. The duration for hospitalization was （6±1.63） day. The rate of postoperative remainder stone was 0%（0/10）. [ Conclusions] If only the indications are mastered, laparoscopic liver resection for hepatolithiasis is a prospective and minimally invasive technique, which can be carried out safely and effectively with decreased postoperative pain and hospital stay time.
出处
《中国内镜杂志》
CSCD
北大核心
2006年第1期21-23,27,共4页
China Journal of Endoscopy
