中国实用外科杂志2017，Vol.37Issue(5)：485-489,5.DOI:10.19538/j.cjps.issn1005-2208.2017.05.07
腹腔镜肝切除术肝静脉系统出血 处理策略
Management strategy of hepatic venous system bleeding in laparoscopic hepatectomy
摘要
Abstract
Hepatic vein bleeding is one of the problems faced in laparoscopic liver resection. It's important that active prevention of bleeding through accurate preoperative imaging evaluation and meticulous laparoscopic operation, as far as possible to avoid the passive treatment after hemorrhage. Intensive anesthesia management as well as controlled low central venous pressure is necessary for successful operation. Emphasis should be put on the diagnosis, prevention and emergency treatment of CO2 gas embolism in the pneumoperitoneum conditions. During the operation, if the hepatic veins injury and bleeding occurred, the severity of bleeding and if it can be controlled laparoscopically should be timely and accurately determined. Once the bleeding has been controlled or reduced, the injured vessel should be isolated, and its diameter, direction and the size and location of the split must be confirmed. Corresponding measures should be applied to make hemostasis rapidly and effectively according to the type and severity of the venous vascular injury, when necessary, conversion to open surgery should be taken rapidly. In recent years, with the accumulation of surgical experiences, the understanding of laparoscopic anatomy of the liver and the constantly updated surgical instruments, the technical level of hepatic vein system bleeding control and treatment during laparoscopic liver resection as well as the safety of the operation has been improved significantly.关键词
腹腔镜/肝切除术/出血/肝静脉Key words
laparoscopy/hepatectomy/hemorrhage/hepatic vein分类
医药卫生引用本文复制引用
郑树国..腹腔镜肝切除术肝静脉系统出血 处理策略[J].中国实用外科杂志,2017,37(5):485-489,5.基金项目
国家卫计委公益性行业科研专项(No.2015SQ00170) （No.2015SQ00170）
第三军医大学西南医院重大领域技术创新项目(No.SWH2016ZDCX2015) （No.SWH2016ZDCX2015）
