Clinical application value of laparoscopic anatomical resection of liver segment 8 <i>via</i> a hepatic parenchymal transection-first approach guided by the middle hepatic vein_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YOU Nan , LI Jing , WU Ke , WANG Zheng , LIU Qinqin , WANG Liang , ZHU Yinan ,  ZHENG Lu

Department of Hepatobiliary Surgery, Xinqiao Hospital, Army Medical University, Chongqing 400037, P. R. China;

Corresponding?author：

ZHENG Lu, Email: xqyyzl1@163.com

Keywords：

liver cancer; middle hepatic vein; hepatic parenchymal transection-first approach; laparoscopic anatomical hepatectomy; liver segment 8

DOI：

10.7507/1007-9424.202012036

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical application value of laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein.Methods Clinical data of 8 patients who underwent laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein in Xinqiao Hospital from May 2017 to December 2019 were retrospectively analyzed. The operation time, intraoperative blood loss, postoperative complications, and hospitalization duration were observed.Results All patients were confirmed by pathology, the postoperative pathological results showed that: hepatocellular carcinoma was found in 6 patients, mixed hepatocellular carcinoma and cholangiocarcinoma was found in 2 patients. All patients completed the operation successfully without conversion to open surgery. The median operation time was 220 min (190-240 min), median blood loss was 230 mL (200-280 mL), and blood transfusion was not needed. The postoperative median hospital stay was 8 d (7–12 d). All the patients recovered well without severe complications. Eight patients were followed up for 10.5 to 31.7 months, with a median follow-up time of 16.9 months. During the follow-up period, none of them developed hemorrhage, bile leakage, and other complications. There was no reoperation or perioperative mortality during the follow-up.Conclusions The method of laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein is safe and effective. This method can shorten the operation time, improve the safety, and reduce the difficulty of operation.

Citation： YOU Nan, LI Jing, WU Ke, WANG Zheng, LIU Qinqin, WANG Liang, ZHU Yinan, ZHENG Lu. Clinical application value of laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(2): 146-150. doi: 10.7507/1007-9424.202012036 Copy

1.	Azagra JS, Goergen M, Gilbart E, et al. Laparoscopic anatomical (hepatic) left lateral segmentectomy-technical aspects. Surg Endosc, 1996, 10(7): 758-761.
2.	Kaneko H, Takagi S, Shiba T. Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series. Surgery, 1996, 120(3): 468-475.
3.	Berardi G, Wakabayashi G, Igarashi K, et al. Full laparoscopic anatomical segment 8 resection for hepatocellular carcinoma using the glissonian approach with indocyanine green dye fluorescence. Ann Surg Oncol, 2019, 26(8): 2577-2578.
4.	Ban D, Tanabe M, Ito H, et al. A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci, 2014, 21(10): 745-753.
5.	Xiang C, Liu Z, Dong J, et al. Precise anatomical resection of the ventral part of Segment Ⅷ. Int J Surg Case Rep, 2014, 5(12): 924-926.
6.	Kim JH. Pure laparoscopic anatomical resection of the segment 8 dorsal area using the transparenchymal Glissonean approach (Video). Surg Oncol, 2019, 31: 99-100.
7.	陳繼業, 蔡守旺. 解剖性肝 S8 段切除手術策略. 臨床外科雜志, 2019, 27(8): 649-651.
8.	王小軍, 曹利, 李建偉, 等. 腹腔鏡解剖性肝臟Ⅷ段切除術. 中華肝膽外科雜志, 2019, 25(2): 135-136.
9.	王曉穎, 高強, 朱曉東, 等. 吲哚菁綠熒光引導腹腔鏡解剖性Ⅷ段切除流程. 中華肝膽外科雜志, 2019, 25(5): 384-385.
10.	劉蘇來, 彭創. 腹腔鏡下解剖性肝Ⅷ段切除的可行性和策略. 肝膽胰外科雜志, 2020, 32(9): 513-515.
11.	Ni ZK, Lin D, Wang ZQ, et al. Precision liver resection: three-dimensional reconstruction combined with fluorescence laparoscopic imaging. Surg Innov, 2020: 1553350620954581.
12.	中華醫學會數字醫學分會, 中國研究型醫院學會數字智能化外科專業委員會, 中國醫師協會肝癌專業委員會. 中央型肝癌三維可視化精準診療中國專家共識 (2020 版). 中國實用外科雜志, 2020, 40(4): 361-368.
13.	Xu Y, Chen M, Meng X, et al. Laparoscopic anatomical liver resection guided by real-time indocyanine green fluorescence imaging: experience and lessons learned from the initial series in a single center. Surg Endosc, 2020, 34(10): 4683-4691.
14.	中國肝膽外科術中超聲學院. 腹腔鏡超聲在肝臟外科的應用專家共識 (2017). 臨床肝膽病雜志, 2018, 34(3): 486-493.
15.	高峰畏, 吳泓, 趙欣, 等. 腹腔鏡肝切除術中肝靜脈出血的原因分析及防治原則. 中國普外基礎與臨床雜志, 2020, 27(6): 675-678.
16.	鄭樹國. 腹腔鏡肝切除術肝靜脈系統出血處理策略. 中國實用外科雜志, 2017, 37(5): 485-489.
17.	蔣利, 吳泓. 腹腔鏡肝切除術的現狀與展望. 中國普外基礎與臨床雜志, 2020, 27(6): 657-661.
18.	Zhang W, Wang J, Li C, et al. Infrahepatic inferior vena cava clamping with Pringle maneuvers for laparoscopic extracapsular enucleation of giant liver hemangiomas. Surg Endosc, 2017, 31(9): 3628-3636.
19.	陳旭東, 王宏光. 應用熒光腹腔鏡術中超聲引導吲哚菁綠反染肝臟 8 段腹側段切除術. 中華外科雜志, 2019, 57(2): 113.

1. Azagra JS, Goergen M, Gilbart E, et al. Laparoscopic anatomical (hepatic) left lateral segmentectomy-technical aspects. Surg Endosc, 1996, 10(7): 758-761.
2. Kaneko H, Takagi S, Shiba T. Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series. Surgery, 1996, 120(3): 468-475.
3. Berardi G, Wakabayashi G, Igarashi K, et al. Full laparoscopic anatomical segment 8 resection for hepatocellular carcinoma using the glissonian approach with indocyanine green dye fluorescence. Ann Surg Oncol, 2019, 26(8): 2577-2578.
4. Ban D, Tanabe M, Ito H, et al. A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci, 2014, 21(10): 745-753.
5. Xiang C, Liu Z, Dong J, et al. Precise anatomical resection of the ventral part of Segment Ⅷ. Int J Surg Case Rep, 2014, 5(12): 924-926.
6. Kim JH. Pure laparoscopic anatomical resection of the segment 8 dorsal area using the transparenchymal Glissonean approach (Video). Surg Oncol, 2019, 31: 99-100.
7. 陳繼業, 蔡守旺. 解剖性肝 S8 段切除手術策略. 臨床外科雜志, 2019, 27(8): 649-651.
8. 王小軍, 曹利, 李建偉, 等. 腹腔鏡解剖性肝臟Ⅷ段切除術. 中華肝膽外科雜志, 2019, 25(2): 135-136.
9. 王曉穎, 高強, 朱曉東, 等. 吲哚菁綠熒光引導腹腔鏡解剖性Ⅷ段切除流程. 中華肝膽外科雜志, 2019, 25(5): 384-385.
10. 劉蘇來, 彭創. 腹腔鏡下解剖性肝Ⅷ段切除的可行性和策略. 肝膽胰外科雜志, 2020, 32(9): 513-515.
11. Ni ZK, Lin D, Wang ZQ, et al. Precision liver resection: three-dimensional reconstruction combined with fluorescence laparoscopic imaging. Surg Innov, 2020: 1553350620954581.
12. 中華醫學會數字醫學分會, 中國研究型醫院學會數字智能化外科專業委員會, 中國醫師協會肝癌專業委員會. 中央型肝癌三維可視化精準診療中國專家共識 (2020 版). 中國實用外科雜志, 2020, 40(4): 361-368.
13. Xu Y, Chen M, Meng X, et al. Laparoscopic anatomical liver resection guided by real-time indocyanine green fluorescence imaging: experience and lessons learned from the initial series in a single center. Surg Endosc, 2020, 34(10): 4683-4691.
14. 中國肝膽外科術中超聲學院. 腹腔鏡超聲在肝臟外科的應用專家共識 (2017). 臨床肝膽病雜志, 2018, 34(3): 486-493.
15. 高峰畏, 吳泓, 趙欣, 等. 腹腔鏡肝切除術中肝靜脈出血的原因分析及防治原則. 中國普外基礎與臨床雜志, 2020, 27(6): 675-678.
16. 鄭樹國. 腹腔鏡肝切除術肝靜脈系統出血處理策略. 中國實用外科雜志, 2017, 37(5): 485-489.
17. 蔣利, 吳泓. 腹腔鏡肝切除術的現狀與展望. 中國普外基礎與臨床雜志, 2020, 27(6): 657-661.
18. Zhang W, Wang J, Li C, et al. Infrahepatic inferior vena cava clamping with Pringle maneuvers for laparoscopic extracapsular enucleation of giant liver hemangiomas. Surg Endosc, 2017, 31(9): 3628-3636.
19. 陳旭東, 王宏光. 應用熒光腹腔鏡術中超聲引導吲哚菁綠反染肝臟 8 段腹側段切除術. 中華外科雜志, 2019, 57(2): 113.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical application value of laparoscopic anatomical resection of liver segment 8 via a hepatic parenchymal transection-first approach guided by the middle hepatic vein

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