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Laparoscopic central hepatectomy using a parenchymal-first approach: how we do it

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机构: [1]Division of Hepatobiliopancreatic Surgery, Department of General Surgery, Nanfang Hospital, Southern Medical University, No.1838, North Guangzhou Avenue, Guangzhou 510515, Guangdong, China [2]Department of Hepatobiliary Surgery, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Guangzhou 510120, Guangdong, China
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关键词: Central hepatectomy Laparoscopy Parenchymal-first approach

摘要:
Background Laparoscopic central hepatectomy (LCH) is a difficult and challenging procedure. This study aimed to describe our experience with LCH using a parenchymal-first approach. Methods Between July 2017 and June 2021, 19 consecutive patients underwent LCH using a parenchymal-first approach at our institution. Herein, the details of this procedural strategy are described, and the demographic and clinical data of the included patients were retrospectively analyzed. Results There were 1 female and 18 male patients, all with hepatocellular carcinoma without major vascular invasion. The mean age was 57 +/- 10 years. No patients underwent conversion to open surgery, and no blood transfusions were needed intraoperatively. The average operative duration and the average Pringle maneuver duration were 223 +/- 65 min and 58 +/- 11 min. respectively. The median blood loss was 200 ml (range: 100-800 ml). Postoperative morbidities occurred in 3 patients (15.8%), including 2 cases of bile leakage and 1 case of acquired pulmonary infection; there were no postoperative complications happened such as bleeding, hepatic failure, or mortality. The average postoperative hospital stay was 10 +/- 3 days. Conclusion The optimized procedure of LCH using a parenchymal-first approach is not only feasible but also expected to provide an advantage in laparoscopic anatomical hepatectomy.

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基金编号: 82070642 2021A1515012485

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 外科
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大类 | 2 区 医学
小类 | 2 区 外科
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Q1 SURGERY
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Q1 SURGERY

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第一作者机构: [1]Division of Hepatobiliopancreatic Surgery, Department of General Surgery, Nanfang Hospital, Southern Medical University, No.1838, North Guangzhou Avenue, Guangzhou 510515, Guangdong, China [2]Department of Hepatobiliary Surgery, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No.111, Dade Road, Guangzhou 510120, Guangdong, China
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