摘要
目的总结腹腔镜肝切除经验。方法回顾性分析本治疗组2012年6月至2015年11月200例腹腔镜肝切除患者资料。按手术方式不同分为左肝手术组及右肝手术组，对比两组患者一般资料、手术相关指标及术后血液指标。结果两组患者一般资料差异无统计学意义。与腹腔镜左肝切除比较，右肝切除手术时间长[（165．5±61．2）min比（135．6±62．5）min，P〈0．05]、术中出血多[（299．0±352．9）ml比（144．3±160．0）ml，P〈0．05]、术后住院天数长[（11．3±4．3）d比（9．4±4．8）d，P〈0．05]。腹腔镜左肝切除基本无需肝门阻断。腹腔镜右肝切除时，肝门阻断的平均时间为（24．1±7．3）min。两组患者术后ALT、AST水平升高。第1、3天右肝切除组ALT、AST水平显著高于左肝切除组；两组患者凝血酶原时间术后下降，差异无统计学意义。结论腹腔镜肝切除治疗肝脏肿瘤安全有效，腹腔镜右肝手术较腹腔镜左肝手术难度大，所需手术时间长、术中出血多、术后住院时间长、需肝门阻断，术后转氨酶水平升高更明显。
Objective To summarize the clinical experience of laparoscopic liver resection （LLR） for liver benign and malignant tumors. Methods Retrospective analysis was performed to review the pooled data of 200 patients treated with laparoscopic liver resection from Qilu Hospital between June 2012 and November 2015. These patients were assigned into left liver group （n = 108） and right liver group （n =86） by tumor sites. The clinical data obtained from the two groups was compared in the aspect of patients＇general information, surgical indicators and postoperative blood workup. Results There was no significant differ- ence in the clinical data between the two groups. The operation duration and post-operative hospitalized days in the group R were significantly longer than those in the group L [ （ 165.5 ＋ 61.2 ） rain vs. （ 135.6 ＋ 62. 5 ） rain, P 〈 0.05 for operative duration ; （ 11.3 ＋ 4.3 ） d vs. （9.4 ＋ 4.8 ） d, P 〈 0.05 for post-operative hospitalized days ]. Blood loss in the group R was significantly more than that in the group L [ （ 299.0 ＋352. 9 ） ml vs. （ 144.3 ＋ 160.0） ml, P 〈 0.051. Hepatic vascular inflow occlusion was more frequently used in laparoscopic right liver resection, the average duration of this procedure was （ 24. 5 ＋ 7.3 ） rain. The levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） elevated on day 1 and day 3 after LLR in both groups, with significant differences observed between the two groups. There was no statisti- cal difference in prothrombin time （ PT ） of patients between the two groups. Conclusions This study suggests that laparoscopic liver resection is safe and effective in the management of liver neoplams. Com- pared with left liver group, the right liver group has been associated with inferior clinical outcomes of surgery complexity, operation duration, blood loss, postoperative hospitalization days, hepatic vascular inflow occlu- sion, and postoperative ALT and AST levels.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2016年第9期587-590,共4页
Chinese Journal of Hepatobiliary Surgery
基金
国家科学自然基金（81571367）
山东大学基础科研项目（2014QLKY18）
关键词
腹腔镜
肝切除
肝肿瘤
经验
Laparoscopy
Liver resection
Liver neoplasm
Experience
