| 摘要 |
Laparoscopic left hepatectomy (segments II, III, and IV) was performed in three patients and laparoscopic left lobectomy (segment II and III) in one for liver tumors. Preoperative diagnosis was hepatocellular carcinoma in two, one suspected to be malignant, and another one was benign. Usually, It was necessary to insert three or four trocars to have an optional operative manipulation. The first trocar was inserted after the pneumoperitoneum was created, and abdominal wall lifting method was used in all four patients. But the abdominal pressure was still maintained at the level of 2-4 mmHg in addition to abdominal lifting where possible. The left hepatic artery, portal vein or hepatic vein was ligated with silk or clip and laparoscopic endo-EIA was never used in these patients. After dissecting the left liver, the specimen could be removed after widening the wound of the port at the epigastrium. The argon beam coagulator was applied to ensure hemostasis on the resection surface. These four patients resumed full diet on the 2nd-3rd day after the operation and were discharged on day 4-6. All patients had high postoperative satifaction. In conclusion, laparoscopic left hepatectomy is becoming feasible for both benign and malignant diseases with today’s laparoscopic techniques and technology. :aparoscopic liver resection is a procedure of significant risk and technocally demanding. |
