腹腔镜肝外格立森鞘外右肝蒂血流阻断新技术应用.pdf

《腹腔镜肝外格立森鞘外右肝蒂血流阻断新技术应用.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、中华胶镜外科杂志(电子版)2014年2月第7卷第1期ChinJLaparoseopicSurgery(ElectronicEdition)，February2014，Vol7，No．1·论著．腹腔镜肝外格立森鞘外右肝蒂血流阻断新技术应用陈焕伟邓斐文王峰杰胡健垣【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

2、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l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。【关键词】肝外格立森鞘外方法；右肝蒂；腹腔镜；右肝切除术AnewextraphepaticGlissonrightliverpedicelbloodflowblockt

3、echniqueappliedinthelaparoscopicrighthepatectomyCHENHuan—wei，DENGFei—wen，WANGFeng-jie，HuJian-yuan．DepartmentofHepaticSurgery，TheFirstPeopleSHospitalofFoshan，FoshanGuangdong，528000，ChinaCorrespondingauthor：CHENHuan—wei，Email：chwei_fsyyy@163．corn[Abstract]0bjectiveT

4、oexplorethefeasibilityandsafetyoftheextraphepaticGlissonrightliverpedicelbloodflowblocktechniqueappliedinthelaparoscopicrighthepatectomy．MethodsEightpatientswithrightliverneoplasmsunderwentlaparoscopichepatectomyfromMarchtoAugust2013，includingthreecasesofhepatocel

5、lularcarcinoma，onelivercarcinomasarcomatodes，oneliverbloodvesselepitheliumliketumor，onecaseofhepatichaemangioma，onecasesofhepaticmetstasiccarcinoma．ExtraphepaticGlissonfightliverpedicelbloodflowblocktechniquewasappliedforthecontrollinghemorrhageintroperaction，whic

6、hwasthroughloweringtheanteriorportahepaticplate，dissectiontheposteriorportahepaticplate，andpassingtherightangleforcepsfinishedtheextrohepaticGlissondissectionandrighliverpedicelbloodflowblock．ResultsRighthemihepatectomywereperformedinthreecases，twoeasesunderwentse

7、gmentV+VIhepatectomy，onecasewithsegmentVI+VIIIhepatectomyandtwocaseswithsegmentVIhepateetomy．Thetimeforthedissectionoftheportahepaticplatewas15—20minutes，andtherewasnohemorrhageandbileleakagecomplications．ConclusionTherighthemihepaticbloodflowblocktechniquethrough

8、theportahepaticplateappliedinthelaparoscopicfighthepatectomywassafe，simpleandrepeatableprocedure，whichshouldinfavouroffacilitatingthelaparoscopicrighthe