Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein
Abstract Background Pure laparoscopic liver resection (LLR) of segment 8 (S8) is still rarely performed due to the lack of an appropriate surgical approach. This article discusses the technical tips and operation methods for LLR of S8 via a hepatic parenchymal transection-first approach. Methods Cli...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-022-02289-8 |
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| author | Nan You Ke Wu Jing Li Lu Zheng |
| author_facet | Nan You Ke Wu Jing Li Lu Zheng |
| author_sort | Nan You |
| collection | DOAJ |
| description | Abstract Background Pure laparoscopic liver resection (LLR) of segment 8 (S8) is still rarely performed due to the lack of an appropriate surgical approach. This article discusses the technical tips and operation methods for LLR of S8 via a hepatic parenchymal transection-first approach. Methods Clinical data of 22 patients who underwent LLR of S8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein (MHV) in the Second Affiliated Hospital, Third Military Medical University (Army Medical University) from May 2017 to February 2020 were retrospectively analyzed. Results The mean age was 51.1 ± 11.6 years; mean operation time, 186.6 ± 18.4 min; median blood loss, 170.0 ml (143.8–205.0 ml); and median length of hospital stay, 8.0 days (7.0–9.0 days). There was no case of open conversion. Pathologic findings revealed all cases of hepatocellular carcinoma (HCC). Pathology showed free surgical margins. Post-operative complications included liver section effusion, pleural effusion, pneumonia, intra-abdomen bleeding and bile leak. All the complications responded well to conservative treatment. No other abnormality was noted during outpatient follow-up examination. All patients survived tumor-free. Conclusions LLR of S8 is still quite challenging at present, and it is our goal to design a reasonable procedure with accurate efficacy and high safety. We use hepatic parenchymal transection-first approach guided by the MHV for LLR of S8. This technique overcomes the problem of high technical risk, greatly reduces the surgical difficulty and achieves technological breakthroughs, but there are still many problems worth further exploration. |
| first_indexed | 2024-12-12T03:18:33Z |
| format | Article |
| id | doaj.art-d13b24e910de412092ff333f9078b309 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T03:18:33Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-d13b24e910de412092ff333f9078b3092022-12-22T00:40:13ZengBMCBMC Gastroenterology1471-230X2022-05-012211910.1186/s12876-022-02289-8Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic veinNan You0Ke Wu1Jing Li2Lu Zheng3Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Third Military Medical University (Army Medical University)Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Third Military Medical University (Army Medical University)Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Third Military Medical University (Army Medical University)Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Third Military Medical University (Army Medical University)Abstract Background Pure laparoscopic liver resection (LLR) of segment 8 (S8) is still rarely performed due to the lack of an appropriate surgical approach. This article discusses the technical tips and operation methods for LLR of S8 via a hepatic parenchymal transection-first approach. Methods Clinical data of 22 patients who underwent LLR of S8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein (MHV) in the Second Affiliated Hospital, Third Military Medical University (Army Medical University) from May 2017 to February 2020 were retrospectively analyzed. Results The mean age was 51.1 ± 11.6 years; mean operation time, 186.6 ± 18.4 min; median blood loss, 170.0 ml (143.8–205.0 ml); and median length of hospital stay, 8.0 days (7.0–9.0 days). There was no case of open conversion. Pathologic findings revealed all cases of hepatocellular carcinoma (HCC). Pathology showed free surgical margins. Post-operative complications included liver section effusion, pleural effusion, pneumonia, intra-abdomen bleeding and bile leak. All the complications responded well to conservative treatment. No other abnormality was noted during outpatient follow-up examination. All patients survived tumor-free. Conclusions LLR of S8 is still quite challenging at present, and it is our goal to design a reasonable procedure with accurate efficacy and high safety. We use hepatic parenchymal transection-first approach guided by the MHV for LLR of S8. This technique overcomes the problem of high technical risk, greatly reduces the surgical difficulty and achieves technological breakthroughs, but there are still many problems worth further exploration.https://doi.org/10.1186/s12876-022-02289-8Laparoscopic liver resectionLiver segment 8Parenchymal transection-firstMiddle hepatic vein |
| spellingShingle | Nan You Ke Wu Jing Li Lu Zheng Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein BMC Gastroenterology Laparoscopic liver resection Liver segment 8 Parenchymal transection-first Middle hepatic vein |
| title | Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein |
| title_full | Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein |
| title_fullStr | Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein |
| title_full_unstemmed | Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein |
| title_short | Laparoscopic liver resection of segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein |
| title_sort | laparoscopic liver resection of segment 8 via a hepatic parenchymal transection first approach guided by the middle hepatic vein |
| topic | Laparoscopic liver resection Liver segment 8 Parenchymal transection-first Middle hepatic vein |
| url | https://doi.org/10.1186/s12876-022-02289-8 |
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