Application of transection of glissionean sheath for laparoscopic anatomic liver resection / 中国内镜杂志

ABSTRACT

Objective To study the clinical value of transection of Glissonean sheath for laparoscopic anatomic liver resections. Methods The patients of liver resections using laparoscopic Glissonean sheath-transection anatomy technology were 20 cases with liver lesions including 12 cases of primary liver cancer, 4 cases of intrahepatic bile duct stones, 2 cases of liver hemangioma,1 case of focal nodular hyperplasia of the liver (FNH) and 1 case of hepatocellular adenomas (HCAs). Results Surgical procedures included segment Ⅱ, Ⅲ,Ⅳ in 6 cases, segmentⅡ, Ⅲ in 5 cases, segmentⅤ, Ⅵ, Ⅶ, Ⅷ in 3 case, segmentⅤin 1 case, segment Ⅵ in 2 cases, segment Ⅵ, Ⅶ in 3 cases. Mean operation time is (144.77 ± 24.68) min. The mean blood loss in operation is (279.00 ± 132.70) ml. The mean postoperative hospital stay is (8.22 ± 1.40) d. Biliary fistula occurred in 1 case, subphrenic infection occurred in 1 case,and it was cured with medical therapy. No postoperative complications such as bleeding occurred. Conclusion Based on these preliminary results, we conclude that laparoscopic Glissonean sheath-transection technology for liver resection can be well applied in laparoscopic liver segment resection above liver resection avoiding problems such as instant bleeding and manipulation of ducts, can be carried out safely and effectively by experienced laparoscopists in selected cases, of whose liver lesions were located in left liver lobe and some segments of right liver lobe.