腹腔镜左侧入路肝尾状叶切除术的解剖基础及临床应用分析OA

Objective:To investigate the anatomical basis of caudate lobectomy,and clarify the clinical application value,indi-cations and safety of the left-sided approach in laparoscopic caudate lobectomy.Methods:A retrospective analysis was conducted on the clinical data of 22 patients with caudate lobe lesions admitted from Jun.2023 to Dec.2025.All patients underwent laparoscopic left-si-ded approach surgery.The key points of surgical operation,intraoperative and postoperative related indicators,pathological results and follow-up outcomes were analyzed.Results:All 22 patients successfully underwent laparoscopic surgery without conversion to laparo-tomy.The operative time ranged from 2.8 to 7.5 h,the intraoperative blood loss was 80～650 mL,and no patients required blood trans-fusion.2 patients had peritoneal effusion after operation,and no severe complications such as massive hemorrhage,bile leakage or liver failure occurred.The time of postoperative drainage tube removal was 3～20 d,the time of basic liver function recovery was 3～7 d,and the total hospital stay was 8～15 d.Postoperative pathological diagnosis included 15 cases of cavernous hemangioma,3 cases of focal nodular hyperplasia and 4 cases of hepatocellular carcinoma,and the preoperative diagnosis was completely consistent with the postope-rative diagnosis.During the follow-up period of 2～25 months,there was no tumor recurrence in all patients,and the patients recovered well.Conclusions:With the anatomical advantages of the left side of the caudate lobe under laparoscopy,the left-sided approach has the characteristics of convenient manipulation and sufficient exposure of the surgical field.It is suitable for most benign lesions of the cau-date lobe and malignant lesions with diameter less than 5 cm and sufficient resection margin from the major hepatic veins.This approach is safe and feasible in clinical application and has high popularization value.