Abstract: ［Abstract］ Objective To explore the advantages of three?dimensional laparoscopic hepatectomy， and to provide experience and skills for surgery procedure. Methods Forty?six cases of laparoscopic hepatectomy for hepatocellular carcinoma from January 2016 to July 2018 were retrospectively analyzed. According surgical procedure， the patients were divided into three?dimensional group （22 cases） and two?dimensional group （24 cases）. The operative time， intraoperative bleeding， postoperative drainage volume， indwelling time of drainage tube and complications were compared between the two groups. Results Compared with the two?dimensional group， the three?dimensional group showed better clinical outcomes， such as lower postoperative complications， shorter operative time， less blood loss， less postoperative drainage volume and time in both hepatic and non?hepatic anatomical resections. （all P values were less than 0.05）. Conclusion Three?dimensional laparoscopy has clearer operative field and smoother operation， especially in hepatic anatomic resection， and is conducive to the overall improvement of the surgeon's surgical level.

Key words: 3?dimensional laparoscopy, 2?dimensional laparoscopy, hepatectomy

摘要： ［摘要］ 目的 探讨三维腹腔镜在肝癌切除术中的优势，为腹腔镜肝癌切除手术提供更精准、完善的方法。方法 回顾分析2016年1月至2018年7月我科行腹腔镜下肝癌切除术病例46例，根据术式分为三维组和二维组，其中三维组22例，二维组24例，全面比较两组病人术时、术中出血、术后引流量、引流管留置时间及并发症。结果 与二维组相比，三维组的术后并发症发生率更低。在肝解剖性切除中，三维组明显缩短手术时间（P=0.017），减少术中出血（P=0.046），减少术后引流量（P=0.039），缩短术后引流管留置时间（P=0.028）。在肝非解剖性切除中，三维组仅能减少术中出血量（P=0.008）。结论 在肝癌切除术应用三维腹腔镜能获得更清晰的术野，使手术更顺利实施，在肝解剖性切除中效果更明显，有利于提高手术的整体水平。

关键词: 二维腹腔镜, 肝癌切除术, 三维腹腔镜