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J Laparoendosc Adv Surg Tech A. 2016 Nov;26(11):862-869. Epub 2016 Aug 11.

An Improved Surgical Technique for Pure Laparoscopic Left Hemihepatectomy: Ten Years Experience in a Tertiary Center.

Author information

1
1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
2
2 Emergency Department, Chinese PLA Navy General Hospital , Beijing, China .

Abstract

BACKGROUND:

This study details our experience with an improved surgical technique involving the hepatic pedicle during laparoscopic left hemihepatectomy (LLH).

METHODS:

We describe an improved laparoscopic technique to extraparenchymally divide the left hepatic pedicle. A retrospective analysis of all of the patients who underwent laparoscopic liver procedures between 2002 and 2012 was conducted. The patients were divided into two groups, an early LLH group (ELLH group) and a recent LLH group (RLLH group), based on the surgical approach used for the left hepatic pedicle.

RESULTS:

A total of 72 cases of LLH (26 ELLH and 46 RLLH) were identified. The RLLH group exhibited a shorter median operative time, median length of hospital stay, and lower median blood loss compared to the ELLH group (182, 162.5-223.7 versus 232.5, 200-357.5 minutes, P < .01; 5, 4.2-7 versus 7, 6-8.7 days, P < .05; 150, 100-257.5 versus 300, 200-337.5 mL, P < .05, respectively). No perioperative mortality was observed.

CONCLUSIONS:

This study confirms that our improved surgical technique for LLH is practical, safe, and effective. The main advantage of this method compared to other techniques is the possibility of attaining rapid and precise control of vascular inflow, thus facilitating LLH.

KEYWORDS:

hemihepatectomy; hepatic pedicle; laparoscopic liver resection; major liver resection; minimally invasive surgery; oncological surgery

PMID:
27513376
PMCID:
PMC5107719
DOI:
10.1089/lap.2016.0047
[Indexed for MEDLINE]
Free PMC Article

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