Clinical application of laparoscopic right hemihepatectomy via anterior approach_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LUO Guosong , QIU Guigang , CHEN Jie , YANG Sen , QING Xiaosong , LIU Xiangdong ,  WANG Xuewen

Department of Hepatobiliary Surgery, Zigong Fourth People’s Hospital, Zigong, Sichuan 643000, P. R. China;

Corresponding author：

WANG Xuewen, Email: 139962800@qq.com

Keywords：

laparoscope; right hemihepatectomy; anterior approach

DOI：

10.7507/1007-9424.202006062

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical application of laparoscopic right hemihepatectomy via anterior approach. Method The clinical data of 32 patients underwent laparoscopic right hemihepatectomy via anterior approach from June 2017 to May 2019 were retrospectively analyzed.Results The laparoscopic right hemihepatectomies via anterior approach were successfully completed in the 32 patients, no one converted to laparotomy. The operation time was (315.5±36.7) min, the intraoperative bleeding was (340.8±105.4) mL, and the postoperative hospital stay was (8.9±1.7) d. The postoperative complications occurred in 6 cases, including 1 case of peritoneal effusion, 1 case of intraabdominal infection, 2 cases of bile leakage and 2 cases of pleural effusion combined with pulmonary infection, who were discharged after receiving the conservative treatment according to the symptoms. The results of postoperative pathology: 13 cases of hepatocellular carcinoma, 6 cases of intrahepatic cholangiocarcinoma, 7 cases of hepatic angioleiomyoma, 6 cases of intrahepatic bile duct stones. The average follow-up time was 12 months (range 1 to 24 months). During the follow-up period, 7 cases of hepatic angioleiomyoma and 6 cases of hepatolithiasis survived after operation. The intrahepatic metastases were found in 1 patient with hepatocellular carcinoma at 12 months and 2 cases of intrahepatic cholangiocarcinoma at 9 months and 11 months, respectively. The rest patients survived free tumor.Conclusion Laparoscopic right hemihepatectomy via anterior approach is safe and feasible, and has a satisfactory short-term efficacy.

Citation： LUO Guosong, QIU Guigang, CHEN Jie, YANG Sen, QING Xiaosong, LIU Xiangdong, WANG Xuewen. Clinical application of laparoscopic right hemihepatectomy via anterior approach. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(4): 461-464. doi: 10.7507/1007-9424.202006062 Copy

1.	Kanazawa A, Tsukamoto T, Shimizu S, et al. Laparoscopic liver resection for treating recurrent hepatocellular carcinoma. J Hepatobiliary Pancreat Sci, 2013, 20(5): 512-517.
2.	Ciria R, Cherqui D, Geller DA, et al. Comparative short-term benefits of laparoscopic liver resection: 9 000 cases and climbing. Ann Surg, 2015, 263(4): 761-777.
3.	Lai EC, Fan ST, Lo CM, et al. Anteriorapproach for difficult major right hepatectomy. World J Surg, 1996, 20(3): 314-317.
4.	Chen YJ, Zhen ZJ, Chen HW, et al. Laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach. Hepatobiliary Pancreact Dis Int, 2014, 13(5): 508-512.
5.	苏正, 刘波, 刘建平, 等. 前入路肝切除在原发性肝癌手术中的应用价值. 中华肝脏外科手术学电子杂志, 2016, 5(1): 16-20.
6.	Shimahara Y, Yamamoto N, Kobayashi N, et al. Anterior approach to dorsal short heptic and right hepatic veins in a right hepatic lobectomy. Nippon Geka Hokan, 1996, 65(1): 13-21.
7.	董健, 朱迎, 郑幸龙, 等. 前入路与常规入路右半肝巨大肝癌切除手术疗效的 Meta 分析. 中华肝胆外科杂志, 2013, 19(9): 649-653.
8.	Meng WC, Shao CX, Mak KL, et al. Anatomical justification of Belghiti’s ‘liver hanging manoeuvre’ in right hepatectomy with anterior approach. ANZ J Surg, 2003, 73(6): 407-409.
9.	李绍强, 梁力建, 彭宝岗, 等. 前入路右半肝切除术与传统右半肝切除术治疗大肝癌的对比观察. 中华医学杂志, 2010, 90(24): 1670-1673.
10.	尹新民, 朱斯维. 腹腔镜肝切除术的进展. 中国普外基础与临床杂志, 2019, 26(2): 129-132.
11.	Takahashi M, Wakabayshi G, Nitta H, et al. Pure laparoscopic righthepatectomy by anterior approach with hanging maneuver for large intrahepatic cholangiocarcinom. Surg Endosc, 2013, 27(12): 4732-4733.
12.	王峻峰, 莫一我, 王彦坤, 等. 前入路绕肝提拉法肝后隧道的解剖学研究. 解剖与临床, 2007, 12(4): 236-239.
13.	Machado MA, Surjan RC, Makdissi FF. Video: intrahepatic Glissonian approach for pure laparoscopic right hemihepatectomy. Surg Endosc, 2011, 25(12): 3930-3933.
14.	Hüscher CG, Lirici MM, Chiodini S, et al. Current position of advanced laparoscopic surgery of the liver. J R Coll Surg Edinb, 1997, 42(4): 219-225.
15.	陈焕伟, 邓斐文, 王峰杰, 等. 全腹腔镜前入路右半肝切除治疗肝细胞癌. 中华肝胆外科杂志, 2017, 23(8): 509-512.
16.	张明雄, 胡晟, 郑梦秋, 等. 腹腔镜与开腹右半肝切除术治疗肝肿瘤疗效比较的 Meta 分析. 中国临床研究, 2020, 33(1): 15-20.
17.	张宇华. 前入路腹腔镜右半肝切除术. 中华外科杂志, 2019, 57(1): 44-45.
18.	许世峰, 司伟, 王建平. 完全腹腔镜下右半肝切除. 中华普外科手术学杂志(电子版), 2017, 11(5): 373.
19.	蔡柳新, 蔡秀军. 腹腔镜右半肝切除术在肝脏疾病治疗中的应用. 浙江省医学会微创外科学分会. 2014年微创外科学术年会论文汇编. 杭州: 浙江省医学会微创外科学分会, 2014.
20.	杜顺达, 金保, 毛一雷. 腹腔镜肝切除术的规范化问题. 中国普外基础与临床杂志, 2019, 26(2): 133-136.
21.	郭鹏, 李建伟, 郑树国. 腹腔镜解剖性右半肝切除术(附视频). 中华肝脏外科手术学电子杂志, 2013, 2(6): 405-406.
22.	周舟, 魏荣光, 段小辉, 等. 腹腔镜循肝中静脉前入路解剖性右半肝切除 35 例临床分析. 肝胆胰外科杂志, 2018, 30(3): 187-190.
23.	Dokmak S, Ben Safta Y, Ftériche FS, et al. Pure laparoscopic right hepatectomy with the hanging maneuver for multiple hepatocellular adenomas. Ann Surg Oncol, 2014, 21(12): 3800-3801.
24.	魏永刚, 张渝翰. 腹腔镜肝脏切除术的肝门血流阻断及断肝技巧. 中国普外基础与临床杂志, 2019, 26(2): 137-140.
25.	Tan J, Tan Y, Zhu Y, et al. Perioperative analysis of laparoscopic liver resection with different methods of hepatic inflow occlusion. J Laparoendosc Adv Surg Tech A, 2012, 22(4): 343-348.

1. Kanazawa A, Tsukamoto T, Shimizu S, et al. Laparoscopic liver resection for treating recurrent hepatocellular carcinoma. J Hepatobiliary Pancreat Sci, 2013, 20(5): 512-517.
2. Ciria R, Cherqui D, Geller DA, et al. Comparative short-term benefits of laparoscopic liver resection: 9 000 cases and climbing. Ann Surg, 2015, 263(4): 761-777.
3. Lai EC, Fan ST, Lo CM, et al. Anteriorapproach for difficult major right hepatectomy. World J Surg, 1996, 20(3): 314-317.
4. Chen YJ, Zhen ZJ, Chen HW, et al. Laparoscopic liver resection under hemihepatic vascular inflow occlusion using the lowering of hilar plate approach. Hepatobiliary Pancreact Dis Int, 2014, 13(5): 508-512.
5. 苏正, 刘波, 刘建平, 等. 前入路肝切除在原发性肝癌手术中的应用价值. 中华肝脏外科手术学电子杂志, 2016, 5(1): 16-20.
6. Shimahara Y, Yamamoto N, Kobayashi N, et al. Anterior approach to dorsal short heptic and right hepatic veins in a right hepatic lobectomy. Nippon Geka Hokan, 1996, 65(1): 13-21.
7. 董健, 朱迎, 郑幸龙, 等. 前入路与常规入路右半肝巨大肝癌切除手术疗效的 Meta 分析. 中华肝胆外科杂志, 2013, 19(9): 649-653.
8. Meng WC, Shao CX, Mak KL, et al. Anatomical justification of Belghiti’s ‘liver hanging manoeuvre’ in right hepatectomy with anterior approach. ANZ J Surg, 2003, 73(6): 407-409.
9. 李绍强, 梁力建, 彭宝岗, 等. 前入路右半肝切除术与传统右半肝切除术治疗大肝癌的对比观察. 中华医学杂志, 2010, 90(24): 1670-1673.
10. 尹新民, 朱斯维. 腹腔镜肝切除术的进展. 中国普外基础与临床杂志, 2019, 26(2): 129-132.
11. Takahashi M, Wakabayshi G, Nitta H, et al. Pure laparoscopic righthepatectomy by anterior approach with hanging maneuver for large intrahepatic cholangiocarcinom. Surg Endosc, 2013, 27(12): 4732-4733.
12. 王峻峰, 莫一我, 王彦坤, 等. 前入路绕肝提拉法肝后隧道的解剖学研究. 解剖与临床, 2007, 12(4): 236-239.
13. Machado MA, Surjan RC, Makdissi FF. Video: intrahepatic Glissonian approach for pure laparoscopic right hemihepatectomy. Surg Endosc, 2011, 25(12): 3930-3933.
14. Hüscher CG, Lirici MM, Chiodini S, et al. Current position of advanced laparoscopic surgery of the liver. J R Coll Surg Edinb, 1997, 42(4): 219-225.
15. 陈焕伟, 邓斐文, 王峰杰, 等. 全腹腔镜前入路右半肝切除治疗肝细胞癌. 中华肝胆外科杂志, 2017, 23(8): 509-512.
16. 张明雄, 胡晟, 郑梦秋, 等. 腹腔镜与开腹右半肝切除术治疗肝肿瘤疗效比较的 Meta 分析. 中国临床研究, 2020, 33(1): 15-20.
17. 张宇华. 前入路腹腔镜右半肝切除术. 中华外科杂志, 2019, 57(1): 44-45.
18. 许世峰, 司伟, 王建平. 完全腹腔镜下右半肝切除. 中华普外科手术学杂志(电子版), 2017, 11(5): 373.
19. 蔡柳新, 蔡秀军. 腹腔镜右半肝切除术在肝脏疾病治疗中的应用. 浙江省医学会微创外科学分会. 2014年微创外科学术年会论文汇编. 杭州: 浙江省医学会微创外科学分会, 2014.
20. 杜顺达, 金保, 毛一雷. 腹腔镜肝切除术的规范化问题. 中国普外基础与临床杂志, 2019, 26(2): 133-136.
21. 郭鹏, 李建伟, 郑树国. 腹腔镜解剖性右半肝切除术(附视频). 中华肝脏外科手术学电子杂志, 2013, 2(6): 405-406.
22. 周舟, 魏荣光, 段小辉, 等. 腹腔镜循肝中静脉前入路解剖性右半肝切除 35 例临床分析. 肝胆胰外科杂志, 2018, 30(3): 187-190.
23. Dokmak S, Ben Safta Y, Ftériche FS, et al. Pure laparoscopic right hepatectomy with the hanging maneuver for multiple hepatocellular adenomas. Ann Surg Oncol, 2014, 21(12): 3800-3801.
24. 魏永刚, 张渝翰. 腹腔镜肝脏切除术的肝门血流阻断及断肝技巧. 中国普外基础与临床杂志, 2019, 26(2): 137-140.
25. Tan J, Tan Y, Zhu Y, et al. Perioperative analysis of laparoscopic liver resection with different methods of hepatic inflow occlusion. J Laparoendosc Adv Surg Tech A, 2012, 22(4): 343-348.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical application of laparoscopic right hemihepatectomy via anterior approach

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