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视频中的患者是1名51岁因肝细胞癌收治于外科和肝移植病房的患者。该患者合并HCV感染引起的肝硬化并门静脉高压形成及食管曲张形态为F1。Child-Pugh评分为B级7分,终末期肝病模型评分为11分,BMI指数为26.7,ASA评分为2分。既往无腹部手术史。多学科诊疗团队意见是为患者实施腹腔镜下左肝叶切除术。术中未采用Pringle法行肝门阻断。手术时间为193 min,失血量约为100 mL,术中无输血。患者术后恢复平稳,Clavien-Dindo分级为1级,并于术后第8天出院。笔者的经验是有经验的手术团队可以在需要手术的肝硬化患者中适当地实施腹腔镜手术。
The patient in the video was a 51-year-old patient with hepatocellular carcinoma who was admitted to a surgical and liver transplant ward. The patient with cirrhosis and portal hypertension caused by HCV infection and esophageal varices morphology F1. Child-Pugh score was grade B 7 points, end-stage liver disease model score 11 points, BMI index 26.7, ASA score 2 points. No past history of abdominal surgery. The opinion of the multidisciplinary team is to perform a laparoscopic left hepatectomy for the patient. Surgery did not use Pringle method of hepatic portal block. Surgery time was 193 min, blood loss was about 100 mL, no blood transfusion during operation. The patient recovered smoothly after operation and Clavien-Dindo was graded as grade 1 and discharged on day 8 postoperatively. The author’s experience is that an experienced surgical team can perform laparoscopic surgery appropriately in patients with cirrhosis requiring surgery.