Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections
Abstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-021-01726-4 |
| _version_ | 1818725148420734976 |
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| author | Shaohe Wang Yang Yue Wenjie Zhang Qiaoyu Liu Beicheng Sun Xitai Sun Decai Yu |
| author_facet | Shaohe Wang Yang Yue Wenjie Zhang Qiaoyu Liu Beicheng Sun Xitai Sun Decai Yu |
| author_sort | Shaohe Wang |
| collection | DOAJ |
| description | Abstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal approach combined with Glissionian appraoch to perform laparoscopic right anatomic hepatectomy (LRAH). Methods Twenty patients who underwent LRAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). The paracaval portion of caudate lobe could be transected firstly through dorsal approach and the corresponding major hepatic vein could be exposed from its root to the peripheral branches safely. Due to exposure along the major hepatic vein trunk, the remaining liver parenchyma could be quickly transected from dorsal to cranial side. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusions Dorsal approach combined with Glissonian approach for right lobe is feasible and effective in laparoscopic right anatomic liver resections. |
| first_indexed | 2024-12-17T21:37:42Z |
| format | Article |
| id | doaj.art-52d4fe3170ad4360873079303ad2cb8a |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-17T21:37:42Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-52d4fe3170ad4360873079303ad2cb8a2022-12-21T21:31:42ZengBMCBMC Gastroenterology1471-230X2021-03-012111810.1186/s12876-021-01726-4Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resectionsShaohe Wang0Yang Yue1Wenjie Zhang2Qiaoyu Liu3Beicheng Sun4Xitai Sun5Decai Yu6Hepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityAbstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal approach combined with Glissionian appraoch to perform laparoscopic right anatomic hepatectomy (LRAH). Methods Twenty patients who underwent LRAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). The paracaval portion of caudate lobe could be transected firstly through dorsal approach and the corresponding major hepatic vein could be exposed from its root to the peripheral branches safely. Due to exposure along the major hepatic vein trunk, the remaining liver parenchyma could be quickly transected from dorsal to cranial side. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusions Dorsal approach combined with Glissonian approach for right lobe is feasible and effective in laparoscopic right anatomic liver resections.https://doi.org/10.1186/s12876-021-01726-4Dorsal approachHepatectomyLaparoscopySurgical procedure |
| spellingShingle | Shaohe Wang Yang Yue Wenjie Zhang Qiaoyu Liu Beicheng Sun Xitai Sun Decai Yu Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections BMC Gastroenterology Dorsal approach Hepatectomy Laparoscopy Surgical procedure |
| title | Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections |
| title_full | Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections |
| title_fullStr | Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections |
| title_full_unstemmed | Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections |
| title_short | Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections |
| title_sort | dorsal approach with glissonian approach for laparoscopic right anatomic liver resections |
| topic | Dorsal approach Hepatectomy Laparoscopy Surgical procedure |
| url | https://doi.org/10.1186/s12876-021-01726-4 |
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