【作者】 李仓； 郑颖； 胡伟建； 厉学民； 俞世安；

【Author】 LI Cang;ZHENG Ying;HU Wei-jian;Department of Hepatobiliary Surgery,Jinhua Central Hospital;

【机构】 金华市中心医院肝胆胰外科；

【摘要】 目的 :探讨腹腔镜超声在腹腔镜小肝癌局部切除术中的价值及临床效果。方法 :回顾性分析我院2015年4月至2017年11月间临床确诊的23例小肝癌患者(肿瘤直径<3cm),手术均行腹腔镜肝癌局部切除,我科于2016年7月购置飞利浦CX-50机组,配置L10-4腹腔镜超声探头,方式分为两组:A组(2016年7月前)13例:未使用腹腔镜超声;B组(2016年7月后)10例:使用腹腔镜超声。分别对比两组间手术时间、术中出血量、平均环周切缘距离及最短环周切缘距离;统计两组间相关手术后并发症包括肝功能(血清胆红素)、胸腹腔积液、切口感染、腹腔出血、围手术期病死率等情况。结果 :B组的平均环周切缘及最少环周切缘距离均比A组长,且均具有统计学意义(P=0.032,P=0.026);两组间肝功能(血清胆红素)无统计学意义(P=0.74);两组术中出血量、手术时间以及相关手术后并发症均未见统计学意义(P=0.33)。结论 :腹腔镜超声在腹腔镜小肝癌局部切除术中的临床效果可靠,能充分保证环周切缘,是腹腔镜小肝癌局部切除术中不可或缺的重要部分。更多还原

【Abstract】 Objective:To eveluate the value and clinical effect of laparoscopic ultrasound in local resection of small hepatocellular carcinoma.Methods:Clinical data of 23 patients of small hepatocellular carcinoma(tumor diameter <3cm) from April 2015 to November 2017 were retrospectively analyzed.Laparoscopic local resection of liver cancer was performed in all cases.Our department purchased the PHILIPS CX-50 which configured L10-4 laparoscopic ultrasound probe in July 2016.Patients were divided into two groups according to operation date.13 patients without laparoscopic ultrasonography(A group,before July 2016);10 patients with laparoscopic ultrasonography(B group,after July 2016).The operation duration,intro-operative blood loss,the average circumferential resection margin distance and the minimum’s,complication about bilirubin,pleural and abdominal effusion,infection of incisional wound,intra-abdominal hemorrhage and perioperative death were analyzed respectively.Results The average circumferential resection margin distance and the minimum’s in group B were longer than those in group A,and both were statistically significant(P = 0.032,P = 0.026),there were no significnt different between the two groups liver functions(serum bilirubin)(P=0.74),intraoperative blood loss,operation duration and operation related complications(P=0.33).Conclusion :The clinical effect of laparoscopic ultrasonography in the local resection of small hepatocellular carcinoma is reliable and can fully ensure the circumferential resection margin distance,which is an indispensable part in the laparoscopic local resection of small hepatocellular carcinoma.更多还原