Journal
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Volume 36, Issue 11, Pages 8630-8638Publisher
SPRINGER
DOI: 10.1007/s00464-022-09163-4
Keywords
Central hepatectomy; Laparoscopy; Parenchymal-first approach
Categories
Funding
- National Natural Science Foundation of China [82070642]
- Natural Science Foundation of Guangdong Province [2021A1515012485]
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This study described the experience of performing laparoscopic central hepatectomy using a parenchymal-first approach. The results showed that this method is feasible, with moderate operative duration, minimal blood loss, and low complication rates.
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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