摘要
目的探讨腹腔镜下肝外格立森鞘外右肝蒂血流阻断技术应用的可行性和安全性。方法从2013年3至8月，我们对8例右肝肿瘤患者实施了腹腔镜肝切除术，其中原发性肝癌3例，肝肉瘤样癌1例，肝血管上皮样肿瘤1例，肝血管瘤2例，肝转移癌1例。术中控制出血方法采用了肝外格立森鞘外右肝蒂血流阻断技术，通过降低前肝门板，分离后肝门板，最后通过直角钳完成肝外右Glisson鞘外的分离及预阻断。结果实施右半肝切除3例，肝5、6段切除2例，肝6、8段切除1例，肝6段切除2例，分离肝门板时间15～20min，无出血及胆漏等并发症。结论腹腔镜下经肝门板右半肝血流阻断技术安全可行、操作简单、可重复性强，该技术的应用有利于促进腹腔镜右肝切除的开展。
Objective To explore the feasibility and safety of the extraphepatic Glisson right liver pedicel blood flow block technique applied in the laparoscopic right hepatectomy. Methods Eight patients with right liver neoplasms underwent laparoscopic hepatectomy from March to August 2013, including three cases of hepatocellular carcinoma, one liver carcinoma sarcomatodes, one liver blood vessel epithelimn like tumor, one case of hepatic haemangioma, one cases of hepatic metstasic carcinoma. Extraphepatic Glisson fight liver pedicel blood flow block technique was applied for the controlling hemorrhage introperaction, which was through lowering the anterior porta hepatic plate, dissection the posterior porta hepatic plate, and passing the right angle forceps finished the extrohepatic Glisson dissection and righ liver pedicel blood flow block. Results Right hemihepatectomy were performed in three cases, two cases underwent segment V ＋VI hepatectomy, one case with segment VI ＋VIII hepatectomy and two cases with segment VI hepatectomy. The time for the dissection of the porta hepatic plate was 15-20 minutes, and there was no hemorrhage and bile leakage complications. Conclusion The right hemihepatic blood flow block technique through the porta hepatic plate applied in the laparoscopic right hepatectomy was safe, simple and repeatable procedure, which should in favour of facilitating the laparoscopic fight hepatectomy.
出处
《中华腔镜外科杂志（电子版）》
2014年第1期17-20,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
广东省科技计划项目（2011106）
关键词
肝外格立森鞘外方法
右肝蒂
腹腔镜
右肝切除术
Extraheptic Glisson dissection technique
Right liver pedicel
Laparoscopy
Right hemihepatectomy
