Clinical study of mixed approach laparoscopic anatomical left hepatectomy for left hepatolithiasis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GAO Fengwei ^1,2 , ZHAO Xin ^1,2 , XIE Qingyun ^1,2

1. Department of Hepatobiliary Pancreatic Surgery, Leshan People’s Hospital of Sichuan, Leshan, Sichuan 614000, P. R. China;
2. Hepatobiliary Pancreatic Splenic Systemic Diseases Center for Diagnosis and Treatment of Leshan City, Leshan, Sichuan 614000,P. R. China;

Corresponding?author：

GAO Fengwei, Email: 707850255@qq.com

Keywords：

hepatolithiasis; mixed approach; laparoscopic left hepatectomy

DOI：

10.7507/1007-9424.202012066

Video：

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Objective To explore the safety and feasibility of mixed approach laparoscopic anatomical left hepatectomy for left hepatolithiasis.Method The clinical data and follow-up results of 23 patients with left hepatolithiasis admitted to the Department of Hepatobiliary Pancreatic Surgery in Leshan People’s Hospital from June 2018 to June 2020 were retrospectively analyzed.Results All 23 patients underwent anatomical left hepatectomy under laparoscopy. The median of total operation time was 185 min (153–460 min), the median of operation time of liver dissection was 110 min (90–125 min), the median of total blood loss during operation was 175 mL (100–800 mL), the median of blood loss from liver dissection was 120 mL (60–560 mL), blood transfusion was performed in 2 patients during operation. Postoperative day 1: median of AST was 75 U/L (32–437 U/L), median of ALT was 83 U/L (25–537 U/L),median of TBIL was 24 μmol/L (15.6–42.7 μmol/L); postoperative day 3: median of AST was 31 U/L (23–129 U/L),median of ALT was 27 U/L (14–108 U/L), median of TBIL was 13.5 μmol/L (10.4–24.3 μmol/L). Postoperative blood transfusion was performed in 1 patient, and the median of postoperative hospital stay was 7 days (5–20 days), median of postoperative extubation time was 2.5 days (2–5 days). Postoperative complications occurred in 3 patients. All 23 patients were followed up after the operation for median of 12 months (6–18 months). During the follow-up period, the patients had no special discomfort, no stone recurrence, reoperation, and death.Conclusion Mixed approach laparoscopic anatomical left hepatectomy is safe and feasible in the treatment of left hepatolithiasis.

Citation： GAO Fengwei, ZHAO Xin, XIE Qingyun. Clinical study of mixed approach laparoscopic anatomical left hepatectomy for left hepatolithiasis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(2): 151-154. doi: 10.7507/1007-9424.202012066 Copy

1.	Lorio E, Patel P, Rosenkranz L, et al. Management of hepatolithiasis: review of the literature. Curr Gastroenterol Rep, 2020, 22(6): 30.
2.	Peng JX, Wang LZ, Diao JF, et al. Major hepatectomy for primary hepatolithiasis: a comparative study of laparoscopic versus open treatment. Surg Endosc, 2018, 32(10): 4271-4276.
3.	謝偉選, 羅昆侖. 肝內膽管結石演變為肝內膽管癌膽管局部微環境的變化. 中華肝膽外科雜志, 2019, 25(7): 553-556.
4.	羅華, 曾新桃, 胡朝輝, 等. 腹腔鏡肝切除術在復雜肝內膽管結石患者中的應用. 中國普外基礎與臨床雜志, 2020, 27(6): 666-670.
5.	黃龍, 王丹鳳, 黃文濤, 等. 循肝中靜脈腹腔鏡解剖性左半肝切除術治療左肝內膽管結石臨床研究. 中國實用外科雜志, 2020, 40(7): 808-812.
6.	Shu J, Wang XJ, Li JW, et al. Robotic-assisted laparoscopic surgery for complex hepatolithiasis: a propensity score matching analysis. Surg Endosc, 2019, 33(8): 2539-2547.
7.	Chen S, Huang L, Qiu FN, et al. Total laparoscopic partial hepatectomy versus open partial hepatectomy for primary left-sided hepatolithiasis: A propensity, long-term follow-up analysis at a single center. Surgery, 2018, 163(4): 714-720.
8.	李越華, 魏東, 王琨, 等. 腹腔鏡與開腹左肝外葉切除聯合膽道鏡取石治療左肝內膽管結石的療效比較. 中國普通外科雜志, 2015, 24(8): 1070-1076.
9.	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.
10.	Yoon YI, Kim KH, Kang SH, et al. Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: A propensity score matched analysis. Ann Surg, 2017, 265(5): 856-863.
11.	Franken C, Lau B, Putchakayala K, et al. Comparison of short-term outcomes in laparoscopic vs open hepatectomy. JAMA Surg, 2014, 149(9): 941-946.
12.	Cheung TT, Dai WC, Tsang SH, et al. Pure laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 110 patients with liver cirrhosis: a propensity analysis at a single center. Ann Surg, 2016, 264(4): 612-620.
13.	陳亞進, 曹君. 從創新到標準化: 腹腔鏡肝切除術進展和展望 (1990-2020). 中國實用外科雜志, 2020, 40(2): 158-162.
14.	張成武. 腹腔鏡解剖性肝切除術的若干進展. 肝膽胰外科雜志, 2020, 32(3): 129-132, 147.
15.	何少武, 吳波, 徐潔, 等. 解剖性肝切除聯合術中膽道鏡治療復雜肝內膽管結石的療效分析. 中華肝膽外科雜志, 2019, 25(9): 681-684.
16.	Li H, Zheng J, Cai JY, et al. Laparoscopic vs open hepatectomy for hepatolithiasis: An updated systematic review and meta-analysis. World J Gastroenterol, 2017, 23(43): 7791-7806.
17.	耿小平. 基于臨床分型的肝膽管結石病治療策略. 中華消化外科雜志, 2020, 19(8): 804-807.
18.	付仕鋒, 黃世華, 李春滿, 等. 一種新的基于膽道解剖及病理的肝膽管結石臨床分型. 中華普通外科雜志, 2019, 34(5): 384-388.
19.	吳鈞, 殷凱, 許建偉, 等. 前入路聯合懸吊法切除右肝大肝癌的療效分析. 中華普通外科雜志, 2019, 34(9): 787-790.
20.	王少和, 余德才, 吳星宇. Glisson肝蒂解剖法聯合背側入路行腹腔鏡左肝切除: 17例報道. 中華腔鏡外科雜志(電子版), 2018, 11(2): 117-120.
21.	李建偉, 鄭樹國, 王小軍, 等. 經頭側入路腹腔鏡解剖性左半肝切除術7例分析. 中國實用外科雜志, 2017, 37(5): 552-554.

1. Lorio E, Patel P, Rosenkranz L, et al. Management of hepatolithiasis: review of the literature. Curr Gastroenterol Rep, 2020, 22(6): 30.
2. Peng JX, Wang LZ, Diao JF, et al. Major hepatectomy for primary hepatolithiasis: a comparative study of laparoscopic versus open treatment. Surg Endosc, 2018, 32(10): 4271-4276.
3. 謝偉選, 羅昆侖. 肝內膽管結石演變為肝內膽管癌膽管局部微環境的變化. 中華肝膽外科雜志, 2019, 25(7): 553-556.
4. 羅華, 曾新桃, 胡朝輝, 等. 腹腔鏡肝切除術在復雜肝內膽管結石患者中的應用. 中國普外基礎與臨床雜志, 2020, 27(6): 666-670.
5. 黃龍, 王丹鳳, 黃文濤, 等. 循肝中靜脈腹腔鏡解剖性左半肝切除術治療左肝內膽管結石臨床研究. 中國實用外科雜志, 2020, 40(7): 808-812.
6. Shu J, Wang XJ, Li JW, et al. Robotic-assisted laparoscopic surgery for complex hepatolithiasis: a propensity score matching analysis. Surg Endosc, 2019, 33(8): 2539-2547.
7. Chen S, Huang L, Qiu FN, et al. Total laparoscopic partial hepatectomy versus open partial hepatectomy for primary left-sided hepatolithiasis: A propensity, long-term follow-up analysis at a single center. Surgery, 2018, 163(4): 714-720.
8. 李越華, 魏東, 王琨, 等. 腹腔鏡與開腹左肝外葉切除聯合膽道鏡取石治療左肝內膽管結石的療效比較. 中國普通外科雜志, 2015, 24(8): 1070-1076.
9. 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.
10. Yoon YI, Kim KH, Kang SH, et al. Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: A propensity score matched analysis. Ann Surg, 2017, 265(5): 856-863.
11. Franken C, Lau B, Putchakayala K, et al. Comparison of short-term outcomes in laparoscopic vs open hepatectomy. JAMA Surg, 2014, 149(9): 941-946.
12. Cheung TT, Dai WC, Tsang SH, et al. Pure laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 110 patients with liver cirrhosis: a propensity analysis at a single center. Ann Surg, 2016, 264(4): 612-620.
13. 陳亞進, 曹君. 從創新到標準化: 腹腔鏡肝切除術進展和展望 (1990-2020). 中國實用外科雜志, 2020, 40(2): 158-162.
14. 張成武. 腹腔鏡解剖性肝切除術的若干進展. 肝膽胰外科雜志, 2020, 32(3): 129-132, 147.
15. 何少武, 吳波, 徐潔, 等. 解剖性肝切除聯合術中膽道鏡治療復雜肝內膽管結石的療效分析. 中華肝膽外科雜志, 2019, 25(9): 681-684.
16. Li H, Zheng J, Cai JY, et al. Laparoscopic vs open hepatectomy for hepatolithiasis: An updated systematic review and meta-analysis. World J Gastroenterol, 2017, 23(43): 7791-7806.
17. 耿小平. 基于臨床分型的肝膽管結石病治療策略. 中華消化外科雜志, 2020, 19(8): 804-807.
18. 付仕鋒, 黃世華, 李春滿, 等. 一種新的基于膽道解剖及病理的肝膽管結石臨床分型. 中華普通外科雜志, 2019, 34(5): 384-388.
19. 吳鈞, 殷凱, 許建偉, 等. 前入路聯合懸吊法切除右肝大肝癌的療效分析. 中華普通外科雜志, 2019, 34(9): 787-790.
20. 王少和, 余德才, 吳星宇. Glisson肝蒂解剖法聯合背側入路行腹腔鏡左肝切除: 17例報道. 中華腔鏡外科雜志(電子版), 2018, 11(2): 117-120.
21. 李建偉, 鄭樹國, 王小軍, 等. 經頭側入路腹腔鏡解剖性左半肝切除術7例分析. 中國實用外科雜志, 2017, 37(5): 552-554.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical study of mixed approach laparoscopic anatomical left hepatectomy for left hepatolithiasis

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