微创医学2024，Vol.19Issue(6)：620-624,5.DOI:10.11864/j.issn.1673.2024.06.05
不同入肝血流阻断方法用于腹腔镜肝切除术的疗效及安全性比较
Comparison of the efficacy and safety of different hepatic inflow occlusion methods applied in laparoscopic hepatectomy
摘要
Abstract
Objective To observe the efficacy and safety of total hepatic inflow occlusion(Pringle maneuver)and selective hepatic inflow occlusion via Glisson's pedicle in laparoscopic hepatectomy.Methods A prospective study was conducted on patients who underwent laparoscopic hepatectomy at Shunde Hospital of Southern Medical University from January 2022 to December 2023.After propensity score matching,60 patients were enrolled and randomly divided into two groups:30 patients in the Glisson group and 30 patients in the Pringle group.The Pringle group underwent total hepatic inflow occlusion,while the Glisson group received selective hepatic inflow occlusion via Glisson's pedicle.The surgical-related indicators,levels of serum total bilirubin(TBiL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),and albumin(ALB),as well as the incidence of postoperative complications were compared between the two groups.Results There was no statistically significant difference in tumor resection margin,operation time and intraoperative blood loss between the two groups(all P>0.05).Compared with the preoperative levels,the levels of TBiL,AST,and ALT in both groups increased,while the ALB level decreased after the surgery.Moreover,postoperatively,the Glisson group had lower levels of TBiL,AST,and ALT and a higher ALB level than the Pringle group,and all these differences were statistically significant(all P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups(20.00%vs.22.67%)(P>0.05).Conclusion Compared with total hepatic inflow occlusion,the use of selective hepatic inflow occlusion via the Glisson's pedicle in laparoscopic hepatectomy does not increase the operation time,intraoperative blood loss,or the incidence of postoperative complications,and it has certain advantages in liver function protection.关键词
肝切除术/全入肝血流阻断/选择性入肝血流阻断/腹腔镜Key words
Hepatectomy/Total hepatic blood inflow occlusion/Selective hepatic blood inflow occlusion/Laparoscopy引用本文复制引用
顾炽昌,刘清波,陈坚平,马靖,区活辉,王卫东..不同入肝血流阻断方法用于腹腔镜肝切除术的疗效及安全性比较[J].微创医学,2024,19(6):620-624,5.基金项目
佛山市卫生健康局医学科研课题(编号:20220330) （编号:20220330）
