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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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.	蘇正, 劉波, 劉建平, 等. 前入路肝切除在原發性肝癌手術中的應用價值. 中華肝臟外科手術學電子雜志, 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, 鄭幸龍, 等. 前入路與常規入路右半肝巨大肝癌切除手術療效的 Meta 分析. 中華肝膽外科雜志, 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.	李紹強, 梁力建, 彭寶崗, 等. 前入路右半肝切除術與傳統右半肝切除術治療大肝癌的對比觀察. 中華醫學雜志, 2010, 90(24): 1670-1673.
10.	尹新民, 朱斯維. 腹腔鏡肝切除術的進展. 中國普外基礎與臨床雜志, 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, 王彥坤, 等. 前入路繞肝提拉法肝后隧道的解剖學研究. 解剖與臨床, 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.	陳煥偉, 鄧斐文, 王峰杰, 等. 全腹腔鏡前入路右半肝切除治療肝細胞癌. 中華肝膽外科雜志, 2017, 23(8): 509-512.
16.	張明雄, 胡晟, 鄭夢秋, 等. 腹腔鏡與開腹右半肝切除術治療肝腫瘤療效比較的 Meta 分析. 中國臨床研究, 2020, 33(1): 15-20.
17.	張宇華. 前入路腹腔鏡右半肝切除術. 中華外科雜志, 2019, 57(1): 44-45.
18.	許世峰, 司偉, 王建平. 完全腹腔鏡下右半肝切除. 中華普外科手術學雜志(電子版), 2017, 11(5): 373.
19.	蔡柳新, 蔡秀軍. 腹腔鏡右半肝切除術在肝臟疾病治療中的應用. 浙江省醫學會微創外科學分會. 2014年微創外科學術年會論文匯編. 杭州: 浙江省醫學會微創外科學分會, 2014.
20.	杜順達, 金保, 毛一雷. 腹腔鏡肝切除術的規范化問題. 中國普外基礎與臨床雜志, 2019, 26(2): 133-136.
21.	郭鵬, 李建偉, 鄭樹國. 腹腔鏡解剖性右半肝切除術(附視頻). 中華肝臟外科手術學電子雜志, 2013, 2(6): 405-406.
22.	周舟, 魏榮光, 段小輝, 等. 腹腔鏡循肝中靜脈前入路解剖性右半肝切除 35 例臨床分析. 肝膽胰外科雜志, 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.	魏永剛, 張渝翰. 腹腔鏡肝臟切除術的肝門血流阻斷及斷肝技巧. 中國普外基礎與臨床雜志, 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. 蘇正, 劉波, 劉建平, 等. 前入路肝切除在原發性肝癌手術中的應用價值. 中華肝臟外科手術學電子雜志, 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, 鄭幸龍, 等. 前入路與常規入路右半肝巨大肝癌切除手術療效的 Meta 分析. 中華肝膽外科雜志, 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. 李紹強, 梁力建, 彭寶崗, 等. 前入路右半肝切除術與傳統右半肝切除術治療大肝癌的對比觀察. 中華醫學雜志, 2010, 90(24): 1670-1673.
10. 尹新民, 朱斯維. 腹腔鏡肝切除術的進展. 中國普外基礎與臨床雜志, 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, 王彥坤, 等. 前入路繞肝提拉法肝后隧道的解剖學研究. 解剖與臨床, 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. 陳煥偉, 鄧斐文, 王峰杰, 等. 全腹腔鏡前入路右半肝切除治療肝細胞癌. 中華肝膽外科雜志, 2017, 23(8): 509-512.
16. 張明雄, 胡晟, 鄭夢秋, 等. 腹腔鏡與開腹右半肝切除術治療肝腫瘤療效比較的 Meta 分析. 中國臨床研究, 2020, 33(1): 15-20.
17. 張宇華. 前入路腹腔鏡右半肝切除術. 中華外科雜志, 2019, 57(1): 44-45.
18. 許世峰, 司偉, 王建平. 完全腹腔鏡下右半肝切除. 中華普外科手術學雜志(電子版), 2017, 11(5): 373.
19. 蔡柳新, 蔡秀軍. 腹腔鏡右半肝切除術在肝臟疾病治療中的應用. 浙江省醫學會微創外科學分會. 2014年微創外科學術年會論文匯編. 杭州: 浙江省醫學會微創外科學分會, 2014.
20. 杜順達, 金保, 毛一雷. 腹腔鏡肝切除術的規范化問題. 中國普外基礎與臨床雜志, 2019, 26(2): 133-136.
21. 郭鵬, 李建偉, 鄭樹國. 腹腔鏡解剖性右半肝切除術(附視頻). 中華肝臟外科手術學電子雜志, 2013, 2(6): 405-406.
22. 周舟, 魏榮光, 段小輝, 等. 腹腔鏡循肝中靜脈前入路解剖性右半肝切除 35 例臨床分析. 肝膽胰外科雜志, 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. 魏永剛, 張渝翰. 腹腔鏡肝臟切除術的肝門血流阻斷及斷肝技巧. 中國普外基礎與臨床雜志, 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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