腹腔镜肝切除术肝实质离断过程中技术要点解析
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中国人民解放军陆军军医大学第二附属医院 肝胆外科,重庆 400037

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郑璐,中国人民解放军陆军军医大学第二附属医院主任医师,主要从事肝胆胰脾疾病微创外科治疗方面的研究。

基金项目:

重庆市科卫联合医学科研项目面上基金资助项目(2023MSXM004);中国人民解放军陆军军医大学科技创新能力提升专项基金资助项目(2022XJS20);中国人民解放军陆军军医大学第二附属医院青年博士人才孵化计划基金资助项目(2022YQB031);重庆市卫生适宜技术推广基金资助项目(2024jstg025)。


Analysis of technical points in the process of liver parenchymal transection during laparoscopic hepatectomy
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Department of Hepatobiliary Surgery, the Second Affifiliated Hospital of Army Medical University, PLA, Chongqing 400037, China

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    摘要:

    肝脏外科手术是腹部外科的难点和技术高峰之一,随着微创手术器械、成像设备的发展和手术技术的进步,腹腔镜肝切除进入了快速发展阶段,但仍然难度大、风险高,存在诸多技术要点,其核心环节之一是肝实质离断过程中技术的掌控,主要体现在入路的选择、断肝平面的确认与校正、器械选择与使用技巧、出血的控制等方面。规范掌握肝实质离断技术,可提高手术完成度,减少术中并发症发生风险,保障腹腔镜肝切除术的精准实施。目前腹腔镜下实质离断还存在很多技术难点,相信随着经验的积累、器械的革新,肝实质离断技术也一定会蓬勃发展,日趋完善。

    Abstract:

    Liver resection is one of the most challenging procedures and technically advanced areas in abdominal surgery. With the development of minimally invasive surgical instruments, imaging equipment, and advances in surgical techniques, laparoscopic liver resection has entered a rapid development stage. However, it remains difficult and high-risk, with many technical considerations. One of the core aspects is the control of techniques during liver parenchymal transection, which mainly involves the selection of the approach, confirmation and correction of the transection plane, choice and use of instruments, and control of bleeding. Mastering liver parenchymal transection techniques can improve the completion rate of surgery, reduce the risk of intraoperative complications, and ensure the precise implementation of laparoscopic liver resection. Currently, there are still many technical challenges in laparoscopic parenchymal transection. It is believed that with the accumulation of experience and innovation in instruments, the techniques for liver parenchymal transection will also develop and become increasingly perfect.

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尤楠,郑璐.腹腔镜肝切除术肝实质离断过程中技术要点解析[J].中国普通外科杂志,2024,33(7):1029-1034.
DOI:10.7659/j. issn.1005-6947.2024.07.001

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  • 收稿日期:2024-01-08
  • 最后修改日期:2024-02-26
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  • 在线发布日期: 2024-08-10