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中华肝脏外科手术学电子杂志 ›› 2025, Vol. 14 ›› Issue (03) : 360 -365. doi: 10.3877/cma.j.issn.2095-3232.2025.03.005

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腹腔镜肝切除术中出血防治策略
林敏杰1, 徐晨囡1, 吴志明1,()   
  1. 1. 312030 浙江省绍兴市,中国医科大学绍兴医院(绍兴市中心医院)普通外科
  • 收稿日期:2024-12-06 出版日期:2025-06-10
  • 通信作者: 吴志明
  • 基金资助:
    浙江省医学会临床科研基金(2019ZYC-A147)

Prevention and treatment of bleeding during laparoscopic hepatectomy

Minjie Lin1, Chennan Xu1, Zhiming Wu1,()   

  1. 1. Department of General Surgery, China Medical University Shaoxing Hospital (Shaoxing Central Hospital), Shaoxing 312030, China
  • Received:2024-12-06 Published:2025-06-10
  • Corresponding author: Zhiming Wu
引用本文:

林敏杰, 徐晨囡, 吴志明. 腹腔镜肝切除术中出血防治策略[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(03): 360-365.

Minjie Lin, Chennan Xu, Zhiming Wu. Prevention and treatment of bleeding during laparoscopic hepatectomy[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 360-365.

自1991年Reich等完成首例腹腔镜下肝良性肿瘤切除术以来,腹腔镜肝切除术(LH)已逐步得到应用及推广。LH的适用范围从良性病变到恶性肿瘤,从局部、肝段切除到半肝切除,甚至活体肝移植供肝切除。随之而来的困难也相应增加,在腹腔镜复杂肝切除术中存在视野受限、触觉缺乏及术中止血困难等问题,导致术中出血风险随之升高。因此,LH术中积极预防及控制出血既是降低围手术期并发症、促进预后的关键之一,也是LH推广及应用的关键。笔者结合文献及团队的体会对LH术中出血防治策略作一简述,供临床医师参考。

Since Reich completed the first case of laparoscopic resection of benign liver tumor in 1991, laparoscopic hepatectomy (LH) has been gradually applied and promoted. The scope of application of LH ranges from benign lesions to malignant tumors, from local and segmental hepatectomy to hemihepatectomy, and even donor hepatectomy in living donor liver transplantation. The challenges of LH are also increased correspondingly. During complicated laparoscopic hepatectomy, limited visual field, lack of tactile sensation and difficulty in intraoperative hemostasis and other issues lead to an increase in the risk of intraoperative bleeding. Therefore, active prevention and control of bleeding during LH is not only one of the keys to reduce perioperative complications and enhance clinical prognosis, but also the key to the promotion and application of LH. In this article, prevention and treatment strategies of bleeding during LH were reviewed based on literature review combined with clinical experience, aiming to provide reference for clinicians.

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