腹腔镜；肝切除；肝脏解剖_____腹腔镜；肝切除；肝脏解剖

完全腹腔镜肝切除的临床应用价值(附123例经验总结)

http://www.100md.com 《腹腔镜外科杂志》 2006年第6期

腹腔镜；肝切除；肝脏解剖,,腹腔镜；肝切除；肝脏解剖,1资料与方法,2结果,3讨论,参考文献：

     【摘要】目的：探讨完全腹腔镜肝切除(total laparoscopic hepatectomy,TLH)的临床应用价值。方法：2002年7月～2006年9月，我院完成完全腹腔镜肝切除123例,其中男83例,女39例,平均48.2(22～69)岁。手术方式包括:解剖性切除65例，局部切除58例。结果：手术时间(105～280)min，平均(2015±1005)min。出血量50～1 500ml,中位数210ml。123例患者中21例输血,输血量400～1 000ml。切除肝体积最大18cm×16cm×12cm,病灶直径1.8～17.0cm，平均(74±25)cm。术后平均住院2～14d，平均(45±15)d。2例出现少量胆漏，经引流,术后第5天愈合。病理报告恶性病变52例，良性病变71例。结论：TLH在一定条件下是治疗某些疾病安全、有效的方法。

    【关键词】腹腔镜；肝切除；肝脏解剖

    Clinical values of total laparoscopic liver resections：with experiences of 123 cases

    LIU RONG，HU Minggen,ZHAO Xiangqian,et al.

    Department of Hepatobiliary Surgery,the PLA General Hospital,Beijing 100853,China

    【Abstract】 Objective:To summarize the clinical experiences of total laparoscopic hepatectomy(TLH).Methods:From July 2002 to Sep.2006,123cases,83 males and 39 females,with a mean age of 48.2 years(range:2269),underwent TLH in our department.Surgical procedures included 65 anatomical hepatectomies and 58 local resections.Results:The operative time was (20.5±100.5) minutes(range:105280).The median intraoperative blood loss was 210ml(rang:501 500).The postoperative hospital stay was(4.5±1.5)days(range:214).The biggest size of the resections was 18cm×16cm×12cm.Biliary fistula occurred in 2 cases postoperatively,which were cured by drainage for 5 days.The pathological result included 52 malignant and 71 benign diseases.Conclusions:TLH is a safe and efficient method for some diseases if it is used properly. ......

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