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首页> 外文期刊>Surgical Endoscopy >Initial experience with laparoscopic hepatic resection at a comprehensive cancer center
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Initial experience with laparoscopic hepatic resection at a comprehensive cancer center

机译：在综合癌症中心进行腹腔镜肝切除的初步经验

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Background: Over the past few years, surgeons have been able to obtain training in advanced minimally invasive surgery (MIS) for hepatic, pancreatic, and biliary (HPB) cases instead of having to teach themselves these complex techniques. As a result, the initial experience of a surgeon with advanced MIS HPB training at a national cancer center was reviewed. Methods: The experience of a surgeon with the first 50 laparoscopic hepatectomies for cancer was reviewed retrospectively. All cases begun with the intention to complete the hepatectomy laparoscopically were included in the laparoscopic group. Results: From November 2008 to October 2010, a total of 57 hepatectomies were performed, with 53 attempted laparoscopically. Of these 57 hepatectomies, 46 (87%) were completed laparoscopically, 4 (7%) required hand assistance, and 3 (6%) were converted to an open approach. Laparoscopic minor hepatectomies were performed for 28 patients and laparoscopic major hepatectomies for 25 patients. The mean operative time was 265 min, and the mean estimated blood loss was 300 ml. The mean hospital stay was 7 days. Complications occurred for six patients (11%) (2 bile leaks, 2 hemorrhages requiring conversion, 1 hernia requiring a hernia repair on postoperative day 7, and 1 ileus managed nonoperatively). Conclusions: Surgeons with advanced MIS HPB training may be able to perform a higher percentage of their hepatectomies laparoscopically. Training in both open and laparoscopic HPB surgery is advisable before these techniques are performed.
机译：背景：在过去的几年中，外科医生已经能够接受针对肝，胰腺和胆道（HPB）病例的高级微创手术（MIS）培训，而不必自己教这些复杂的技术。结果，回顾了在国家癌症中心接受过高级MIS HPB培训的外科医生的初步经验。方法：回顾性回顾了前50名腹腔镜肝切除术的外科医生的经验。所有以腹腔镜完成肝切除术为目的的病例都包括在腹腔镜组中。结果：自2008年11月至2010年10月，共进行了57例肝切除术，其中53例行腹腔镜手术。在这57例肝切除术中，有46例（87％）已通过腹腔镜手术完成，其中4例（7％）需要手部帮助，而3例（6％）已转变为开放式。腹腔镜小肝切除术28例，腹腔镜大肝切除术25例。平均手术时间为265分钟，平均估计失血量为300毫升。平均住院时间为7天。 6例患者发生并发症（11％）（2例胆汁渗漏，2例出血需要转化，1例疝气需要在术后第7天进行疝气修补，而1例肠梗阻是非手术治疗的）。结论：接受过MIS HPB培训的外科医生可能能够通过腹腔镜执行更高比例的肝切除术。在进行这些技术之前，建议进行开放式和腹腔镜HPB手术培训。

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