Application value of Laennec approach in laparoscopic anatomical right hemihepatectomy
10.3760/cma.j.cn115610-20210616-00286
- VernacularTitle:Laennec入路在腹腔镜解剖性右半肝切除术中的应用价值
- Author:
Wei HU
1
;
Gongming ZHANG
;
Meng CHEN
;
Xiaqing GE
;
Lei SUN
;
Xitai SUN
;
Zhong WANG
;
Kai LI
Author Information
1. 南京医科大学康达学院第一附属医院肝胆外科，连云港 222001
- Keywords:
Hepatic neoplasms;
Hemangiomas;
Surgical approach;
Right hemi-hepatectomy;
Laennec capsule;
Laparoscopy
- From:
Chinese Journal of Digestive Surgery
2021;20(7):815-821
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the application value of Laennec approach in laparoscopic anatomical right hemihepatectomy (LARH).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 2 female patients who underwent LARH via Laennec approach in the First Affiliated Hospital of Kangda College of Nanjing Medical University from May to July 2020 were collected. The two patients were 51 and 57 years old, respectively. Observation indicators: (1) surgical situations; (2) postoperative situations and follow-up. Follow-up using outpatient examination and telephone interview was conducted to detect post-operative survival and tumor recurrence of patients up to December 2020. Count data were repre-sented as absolute numbers.Results:(1) Surgical situations: 2 patients successfully underwent LARH via Laennec approach, without conversion to open surgery. The operation time was 180 minutes and 185 minutes, and the volume of intraoperative blood loss was 200 mL and 400 mL, respectively. No blood transfusion or gastrointestinal decompression was performed in either patient. (2) Postoperative situations and follow-up: 2 patients began to take liquid diet on the first day and out-of-bed activities on the postoperative second to third day. There was no postoperative bile fistula or bleeding, but different degrees of peritoneal and pleural effusion occurred to the 2 patients after operation. One case was improved after right-sided thoracentesis and chest tube drainage due to dyspnea, and the other case was cured after conservative therapy. There was no perioperative death. The duration of postoperative hospital stay of 2 patients was 13 days and 11 days, respectively. Results of pathological examination showed 1 case of hepatic hemangioma and 1 case of primary liver cancer, respectively. The Laennec capsule was observed on the hepatic vein branches of segment Ⅴ, Ⅵ, Ⅶ, Ⅷ, and the gap existed between the Laennec capsule and the hepatic vein. Two patients were followed up for 7 months and 5 months，respectively. They survived during the follow-up，without tumor recurrence.Conclusion:It is safe and feasible to perform LARH by Laennec approach.
