探讨半肝血流阻断在腹腔镜肝细胞癌（肝癌）切除中的安全性及疗效。

回顾性分析2013年1月至2015年12月佛山市第一人民医院收治的23例腹腔镜肝癌切除术患者临床资料。患者均签署知情同意书，符合医学伦理学规定。根据第一肝门血流阻断方式不同将患者分为半肝血流阻断组和Pringle组。其中半肝血流阻断组11例，男9例，女2例；年龄24～65岁，中位年龄46岁；采用腹腔镜下经肝门板半肝血流阻断。Pringle组12例，男10例，女2例；年龄31～66岁，中位年龄43岁；采用腹腔镜下Pringle法肝门血流阻断。观察两组患者术中、术后情况以及围手术期肝功能变化。两组肝功能、住院时间比较采用t检验。

半肝血流阻断组术后7 d ALT、TB、ALB分别为（58±12） U/L、（29±2） μmol/L、（38±3） g/L，Pringle组相应为（80±24）U/L、（32±3） μmol/L、（34±4） g/L，差异有统计学意义（t=-2.739，-2.192，2.626；P<0.05)。半肝血流阻断组术后住院时间（5.9±0.9） d，明显短于Pringle组的（7.4±1.9）d（t=-2.382，P<0.05）。两组均无中转开腹，无发生围手术期死亡及肝衰竭、术后出血等严重并发症。

腹腔镜肝癌切除术中采用半肝血流阻断安全、可行，与Pringle法相比，具有术后恢复快优势，是腹腔镜肝切除理想的肝血流阻断方法之一。

To investigate the safety and efficacy of hemihepatic vascular occlusion in laparoscopic resection of hepatocellular carcinoma (HCC).

Clinical data of 23 patients who underwent laparoscopic resection of HCC in the First People's Hospital of Foshan between January 2013 and December 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the vascular occlusion method of the porta hepatis, the patients were divided into the hemihepatic vascular occlusion group (n=11) and Pringle group (n=12). In the hemihepatic vascular occlusion group, 9 cases were males and 2 females, aged 24-65 years old with a median age of 46 years old, and laparoscopic hemihepatic vascular occlusion via the portal plate was performed. In the Pringle group, 10 cases were males and 2 females, aged 31-66 years old with a median age of 43 years old, and laparoscopic vascular occlusion of the porta hepatis with Pringle maneuver was performed. The intraoperative and postoperative conditions and liver function changes in the perioperative period were observed in two groups. Liver function and length of hospital stay were compared between two groups using t test.

The ALT, TB and ALB levels at postoperative 7 d was respectively (58±12) U/L, (29±2) μmol/L, (38±3) g/L in the hemihepatic vascular occlusion group, and (80±24) U/L, (32±3) μmol/L, (34±4) g/L in the Pringle group, and significant differences were observed (t=-2.739, -2.192, 2.626; P<0.05). The postoperative length of hospital stay in the hemihepatic vascular occlusion group was (5.9±0.9) d, significantly shorter than (7.4±1.9) d in the Pringle group (t=-2.382, P<0.05). No patient was switched to open surgery, no death in the perioperative period was observed, and no liver failure, postoperative hemorrhage or other severe complications were observed in both groups.

Hemihepatic vascular occlusion is safe and feasible for laparoscopic resection of HCC. Compared with Pringle maneuver, it has the advantage of faster postoperative recovery. It is an ideal hepatic vascular occlusion method for laparoscopic hepatectomy.