摘要
目的比较逆行性和顺行性两种不同的方法行腹腔镜左半肝切除的安全性和疗效。方法回顾性分析2016年1月至2018年6月宁波市医疗中心李惠利医院收治的65例行腹腔镜左半肝切除术患者临床资料,依据不同手术方式分为逆行性组(n=31)和顺行性组(n=34)。比较两组患者围手术期的一般资料、手术时间、术中出血量、术后住院时间以及术后出血、腹腔脓肿和胆漏等并发症情况。结果两组患者围手术期一般资料比较,差异无统计学意义(均P>0.05)。两组患者手术时间[(121.5±22.1)min比(190.9±48.9)min]和术中出血量[(118.9±84.1)ml比(195.2±85.4)ml],逆行组均少于顺行组,差异有统计学意义(均P<0.05)。两组患者术后均无出血,腹腔脓肿、胆漏等并发症以及术后住院时间[(10.0±2.8)d比(12.2±3.4)d],差异均无统计学意义(均P>0.05)。结论从第二肝门到第一肝门、入肝和出肝血流阻断的逆行性左半肝切除安全、可行,在腹腔镜左半肝切除中,逆行性方法要优于顺行性。
Objective To compare the safety and efficacy of the retrograde and the antegrade techniques in laparoscopic left hemihepatectomy.Methods Of the 65 patients who underwent laparoscopic left hemihepatectomy between January 2016 to June 2018 at the Ningbo Li Huili Hospital of Medical Center,retrograde left hemihepatectomy was carried out in 31 patients,and antegrade left hemihepatectomy in 34 patients.The perioperative data,duration of operation,intraoperative blood loss,postoperative complications(including major bleeding,abdominal abscess and bile leakage),and post-operative hospital stay were retrospectively compared between the two groups.Results There were no significant differences in the perioperative general status between the two groups(P>0.05).Both the duration of operation[(121.5±22.1)min vs.(190.9±48.9)min,P<0.05]and the amount of blood loss[(118.9±84.1)ml vs.(195.2±85.4)ml,P<0.05]were significantly less in the retrograde than the antegrade group.There were no statistical differences in the incidences of major complications such as post-hepatectomy hemorrhage,abdominal abscess,or bile leakage,and in the postoperative hospital stay[(10.0±2.8)d vs.(12.2±3.4)d,P>0.05].Conclusions Occlusion of hepatic vascular inflow and outflow combined with retrograde left hemihepatectomy was safe and feasibly.The retrograde approach was superior to the antegrade approach in laparoscopic left hemihepatectomy.
作者
陈佰文
裘铠杰
李宏
王海彪
Chen Baiwen;Qiu Kaijie;Li Hong;Wang Haibiao(Department of Hepatobiliary and Pancreatic Surgery,Ningbo Medical Center Li Huili Hospital,Ningbo 31540,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2019年第11期815-818,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
腹腔镜
肝切除术
逆行性
顺行性
Laparoscopes
Hepatectomy
Retrograde
Antegrade
