Laennec膜解剖下腹腔镜肝Ⅴ/Ⅷ段切除术
Laparoscopic hepatic segment Ⅴ/Ⅷ resection by Laennec membrane dissection
徐思远 1杨勇 1陈晶 1蔡辉华1
作者信息
- 1. 苏州大学附属第三医院,常州市第一人民医院肝胆胰外科,江苏常州,213003
- 折叠
摘要
腹腔镜肝脏解剖性切除已经被认可并广泛使用,按手术入路可分为"肝实质优先法"及"肝蒂优先法".前者即在全肝血流阻断后,沿着预切线离断肝实质,暴露目标肝蒂后再切除;后者以肝脏Glisson系统为解剖依据,通过目标肝脏Glisson蒂鞘内解剖或鞘外解剖阻断肝脏的入肝血流,然后沿着缺血线行肝实质离断,其中鞘外解剖法具有简便、易行等优势,目前已广泛运用于腹腔镜下解剖性肝切除术中.本次手术沿Laennec膜鞘外阻断肝Ⅴ、Ⅷ段肝蒂,循缺血线及肝中静脉、肝右静脉行解剖性肝Ⅴ、Ⅷ段切除术,手术方法可靠、安全、易行,值得在临床中推广应用.
Abstract
Laparoscopic anatomic liver resection has been recognized and widely used.According to the surgical approach,it can be divided into"Liver Parenchyma-First Approach"and"Hepatic Pedicle-First Approach".The former involves liver parenchymal dissection along a predetermined line after total hepatic blood flow occlusion,exposing the target hepatic pedicle before resection.The latter relies on the Glisson system of the liver for anatomical guidance,employing either intra-sheath or extra-sheath dissection of the target hepatic Glisson pedicle to block hepatic inflow,followed by liver parenchymal dissection along the ischemic line.The extra-sheath dissection method has the advantages of simplicity and convenience,and has been widely used in laparoscopic anatomical liver resections.In this study,segments Ⅴ/Ⅷ of the liver were blocked along the Laennec membrane sheath,and anatomical resection of segments Ⅴ/Ⅷ of the liver was performed along the ischemic line,middle hepatic vein and right hepatic vein.The surgical method is reliable,safe and easy,and worthy of clinical application.
关键词
Laennec膜解剖/鞘外阻断/解剖性肝切除Key words
Laennec membrane anatomy/extra-sheath blockade/anatomical liver resection引用本文复制引用
出版年
2024
NETL
NSTL
万方数据