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首页> 外文期刊>Surgical laparoscopy, endoscopy and percutaneous techniques >Laparoscopic Anatomic Spiegel Lobectomy With the Extrahepatic Glissonean Approach
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Laparoscopic Anatomic Spiegel Lobectomy With the Extrahepatic Glissonean Approach

机译：腹腔镜解剖学Spiegel Lobectomy与脱皮无光泽的方法

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Background: Laparoscopic Spiegel lobectomy is difficult due to its deep location and being surrounded by gross vessels. Extrahepatic Glissonean pedicle transection method has been proposed by Takasaki during open liver resections. This approach can be successfully performed during laparoscopic anatomic hepatectomy. Here we describe pure laparoscopic Spiegel lobectomy using the extrahepatic Glissonean approach. Methods: The patient was a 25-year-old male with a background of hepatitis B. A 1.5 cmx1.7 cm mass was detected in liver Spiegel lobe and highly suspected to be an hepatocellular carcinoma. The liver function was normal (Child-pugh 5), and alpha-fetoprotein was within the normal ranges. Laparoscopic Spiegel lobectomy using extrahepatic Glissonean approach was proposed. The hilar plate was partly detached from liver parenchyma, and 2 Glissonean pedicles of the Spiegel lobe were dissected, clamped and divided. Liver parenchymal transection was performed using the harmonic scalpel. Results: The operation time was 196 minutes without Pringle's maneuver. Estimated blood loss was <50 mL, and no blood transfusion was required. The patient recovered well and was discharged on postoperative day 6. There was no complication. Pathologic findings support the diagnosis of hepatocellular carcinoma. Conclusions: Laparoscopic Spiegel lobectomy using the extrahepatic Glissonean approach is safe and feasible.
机译：背景：腹腔镜Spiegel Lobectomy由于其深层位置并且被大容器包围而困难。高崎在公开肝切除期间提出了脱膜椎弓根椎弓根转化方法。可以在腹腔镜解剖学肝切除术期间成功地进行这种方法。在这里，我们使用诸如脱皮无光泽的方法来描述纯腹腔镜Spiegel Lobectomy。方法：该患者是一只25岁的男性，乙型肝炎背景。在肝纤维叶中检测到1.5cmx1.7cm的质量，并受到高度怀疑的是肝细胞癌。肝功能正常（儿童-PUGH 5），并且α-胎蛋白在正常范围内。提出了使用脱垂无光泽度方法的腹腔镜Spiegel Lobectomy。 Hill板部分从肝脏擦床中分离出来，分离，夹紧和分开了2个斑叶叶的阴道椎弓根。使用谐波手术刀进行肝实质转化。结果：运行时间为196分钟，没有Pringle的机动。估计失血量<50毫升，不需要输血。患者恢复良好并在术后第6天出院。没有并发症。病理研究结果支持肝细胞癌的诊断。结论：腹腔镜纺粘使用脱垂无光泽度方法是安全可行的。

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