Langenbeck's Archives of Surgery ( IF 2.1 ) Pub Date : 2023-09-26 , DOI: 10.1007/s00423-023-03116-8 Jie Huang 1 , Ding-Wei Xu 1 , Xin-Cheng Li 1 , Ao Li 1 , Yan Zhang 1 , Manqing Hu 1
Background/aim
Laparoscopic hepatectomy has become a common management strategy for liver tumors owing to its less invasive nature and enhanced visual perspective. Yet, its use in the caudate lobe poses challenges. This study evaluates the experiences of patients who underwent laparoscopic hepatectomy for hepatic tumors in the caudate lobe and aims to propose strategies for performing such procedures.
Methods
We retrospectively analyzed the clinical data of twelve patients who underwent laparoscopic hepatic caudate lobe resection at the Department of Hepatopancreatobiliary Surgery, Second Affiliated Hospital of Kunming Medical University.
Results
All twelve laparoscopic procedures were successful, with none requiring conversion to open surgery. The surgical methods varied: five cases involved simple resection of the Spiegel lobe, one case involved total caudate lobe resection, three cases involved paravena cava lobe resection, and three cases involved resection of the caudate process. The operation time ranged from 49 to 319 min (mean, 219 min). Intraoperative blood loss ranged from 20 to 500 ml, averaging 194 ml. No patients needed blood transfusions during or after the operation, and there were no instances of postoperative bleeding, bile leakage, or abdominal infection.
Conclusion
Given adequate control of hepatic inflow, sufficient exposure to the surgical field, and an appropriate approach, laparoscopic hepatectomy in the caudate lobe could potentially become a standard surgical technique.
中文翻译:
腹腔镜手术是肝尾叶良性病变的首选吗?
背景/目标
腹腔镜肝切除术由于其侵入性较小且视野增强,已成为肝脏肿瘤的常见治疗策略。然而,它在尾状叶的使用带来了挑战。本研究评估了因尾状叶肝肿瘤接受腹腔镜肝切除术的患者的经历,旨在提出执行此类手术的策略。
方法
回顾性分析昆明医科大学第二附属医院肝胆胰外科收治的12例腹腔镜肝尾状叶切除术患者的临床资料。
结果
所有 12 例腹腔镜手术均获得成功,无需中转开腹手术。手术方式多样:单纯镜叶切除5例,尾状叶全切除1例,腔静脉旁叶切除3例,尾状突切除3例。手术时间49~319分钟,平均219分钟。术中失血量20~500毫升,平均194毫升。术中及术后无患者需要输血,无术后出血、胆漏、腹部感染等情况。
结论
如果充分控制肝血流、充分暴露手术区域以及适当的方法,腹腔镜尾状叶肝切除术有可能成为一种标准手术技术。