HabibTM 4X在腹腔镜肝切除中的应用体会(附38例报告)
王卫东;陈小伍;林杰;梁智强;吴志强;冯剑平;刘清波;何威;陈坚平
【期刊名称】《腹腔镜外科杂志》 【年(卷),期】2013(018)003
【摘要】Objective: To evaluate the clinic value of bipolar radiofrequency device-the laparoscopic Habib 4X(LH4X) using in total laparoscopic hepatectomy. Methods: From Oct. 2010 to Oct. 2012 , laparoscopic hepatectomy was performed with the laparoscopic HabibTM 4X in 38 patients. The laparoscopic HabibTM 4X was introduced into the liver to\produce coagulative necrosis of the liver parenchyma, and seal biliary ducts and blood vessels along the precoagulative line. Then, the liver parenchyma was cut off and the major vessels and bile ducts were ligated step by step until liver lesion was completely removed. Results:The
operation
was
completed
successfully
in
37
patients,including 22 cases of irregular hepatectomy, 12 cases of left lateral lobectomy of liver and 3 cases of anatomical left hepatectomy. One patient was converted to laparotomy. The mean operative time was ( 162 ±64) min ( range,80-320 min). Mean blood loss was (163 ± 183 ) ml ( range, 10-900 ml) . No patient died during hospital stay. Three patients suffered from bleeding of ligament teres hepatis at transumbilical
incision,intra-abdominal
abscess
and
pulmonary
infection,respectively. No patients experienced other postoperative
complications such as bleeding from liver resection margins,bile leakage,liver failure and so on. The mean hospital stay after surgery was (9 ±3) d (range,5-20 d). The follow-up period was 2-23 months lor 37 patients,5 patients with intrahepatic stone had no residual stone. In the 4 hepatocellular carcinoma patients,3 got intrahepatic tumor recurrence at postoperative 2,4 and 8 months, 1 got intrahepatic and pulmonary metastasis at postoperative 5 months, and all were treated with transcatheter arterial chemoemboliza-tion. The other patients had no tumor recurrence or metastasis. Conclusions: The laparoscopic HabibTM 4X used for laparoscopic hepatectomy in selected cases is safe,feasible,efficient and ideal,and worthy of popularization in clinic.%目的:探讨HabibTM4X在腹腔镜肝切除中的应用价值.方法:回顾分析2010年10月至2012年10月为38例患者应用HabibTM4X行腹腔镜肝切除术的临床资料.术中应用HabibTM4X按预先标定的肝切除线凝闭肝组织,分离肝实质、结扎主要管道后切除病灶.结果:37例成功完全腹腔镜手术,l例中转开腹.其中22例行不规则肝切除术,12例行肝左外叶切除术,3例行解剖性左半肝切除术.手术时间80 ～320 min,平均(162±64) min；术中出血量10 ～900 ml,平均(163±183) ml.无死亡病例.术后1例脐缘切口处肝圆韧带出血,1例发生腹腔脓肿,1例肺部感染,无肝断面出血、胆漏、肝功能衰竭等严重并发症发生.术后住院5 ～ 20 d,平均(9±3) d.随访2～23个月,3例肝细胞癌患者分别于术后2、4、8个月出现肝内复发转移,1例肝细胞癌患者术后5个月出现肝内及肺部转移,均行经导管动脉化学栓塞治疗；余28例均无肿瘤复发、转移.结论:HabibTM
4X(腹腔镜型)适用于腹腔镜肝切除术,是安全、可行、有效、理想的腹腔镜下切肝器械,值得临床推广. 【总页数】5页(168-172)
【关键词】肝切除术;腹腔镜检查;HabibTM 4X
【作者】王卫东;陈小伍;林杰;梁智强;吴志强;冯剑平;刘清波;何威;陈坚平 【作者单位】佛山市顺德区第一人民医院,广东佛山,528300 【正文语种】中文 【中图分类】R657.3 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_journal-laparoscopic-surgery_thesis/0201233597775.html 【相关文献】
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HabibTM 4X在腹腔镜肝切除中的应用体会(附38例报告)
