腹腔镜右半肝切除术1例右优势多囊性肝病。

Hideaki Andoh, Tsutomu Sato, Ouki Yasui, Satoshi Shibata, Toshiaki Kurokawa
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引用次数: 19

摘要

背景/目的:报告1例右侧优势多囊性肝病行腹腔镜右半肝切除术。病人:一名43岁女性,主诉右上腹部疼痛前来求诊。腹部超声及电脑断层检查显示多发性肝囊肿,主要占右叶,肾囊肿及脾肿大。方法:使用4个套管针。在脐下放置12mm套管针进行腹部探查。另外三个套管针,两个12毫米套管针和一个5毫米套管针,用作工作端口。用超声剪刀和LigaSure切除肝脏。用血管内吻合器分离主要血管,如右门静脉、右胆管、肝静脉。手术时间320 min,术中出血量120 ml,术后第3天口服。结果:围手术期无并发症发生。结论:腹腔镜右半肝切除术通常被认为术中出血过多,手术时间长。对于我们的多发肝囊肿患者,该手术是一种安全且微创的选择,因为多发囊肿只需少量肝实质切除术。本文报告一例右优势多囊性肝病行腹腔镜右半肝切除术。
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Laparoscopic right hemihepatectomy for a case of polycystic liver disease with right predominance.

Background/purpose: A case of polycystic liver disease with right predominance treated with laparoscopic right hemihepatectomy is described.

Patient: A 43-year-old woman complaining of right upper abdominal pain came in for consultation. Abdominal ultrasonography and computed tomography studies showed multiple liver cysts occupying mainly the right lobe, renal cysts, and splenomegaly.

Methods: Four trocars were used. A 12-mm trocar placed under the umbilicus was used for abdominal exploration. The other three trocars, two 12-mm trocars and one 5-mm trocar, were used as working ports. The liver was transected with ultrasound scissors and LigaSure. Major vessels such as the right portal vein, the right bile duct, and the hepatic vein were divided with a vascular endostapler. Operation time was 320 min, intraoperative blood loss was 120 ml, and postoperative oral intake occurred on day 3.

Results: No complication was observed during the perioperative period.

Conclusions: Laparoscopic right hemihepatectomy is generally considered to cause excessive intraoperative bleeding and a long operation time. For our patient with multiple liver cysts, the procedure was a safe and minimally invasive option because little hepatic parenchymal resection was necessary for the multiple cysts.A case of polycystic liver disease with right predominance treated with laparoscopic right hemihepatectomy is described.

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