Application of rapid division of left Glisson pedicle and Arantius tube in laparoscopic anatomical left hemihepatectomy
10.3760/cma.j.cn113884-20241224-00390
- VernacularTitle:"一枪法"快速离断左Glisson蒂及Arantius管平面在腹腔镜解剖性左半肝切除术中的应用分析
- Author:
Yijian ZOU
1
;
Dawei CHEN
1
;
Xiaodong TANG
1
;
Sheng CHEN
1
;
Biao ZHOU
1
;
Yitao HUANG
1
;
Shuanghai LIU
1
Author Information
1. 南通大学附属江阴医院肝胆胰外科，江阴 214400
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Hepatectomy;
Laparoscopes;
Gallstones;
Glisson pedicle
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(3):208-213
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the effect of rapid division of left Glisson pedicle and Arantius tube plane in laparoscopic anatomical left hemihepatectomy (LALH).Methods:Clinical data of 25 patients (15 with intrahepatic bile duct calculus and 10 with liver tumor) undergoing LALH in the Department of Hepatobiliary and Pancreatic Surgery, Jiangyin Hospital Affiliated to Nantong University from June 2020 to November 2024 were retrospectively analyzed, including 14 males and 11 females, aged (66.6±11.9) years. Among the patients, 15 received LALH with rapid division of left Glisson pedicle and Arantius tube plane in " one-clamp" fashion, and the others received LALH after traditional dissection of left Glisson pedicle. Age, sex, body mass index, time of left Glisson pedicle dissection, whether the MHV exposure, the time of liver transection, whether MHV and its important branches or bile duct injury occurred, intraoperative blood loss, the incidence of postoperative biliary leakage, the time of abdominal drainage remove, the hospital stay, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, albumin 3 days after postoperative were compared between the groups.Results:The times of left Glisson pedicle dissection in the new-fasion and traditional group were (6.1±1.6) min and (13.8±3.0) min, and the time of liver transection was (24.9±3.5) min and (33.4±3.3) min, respectively ( t=-8.34, 6.08, P<0.001 for both). After division of left Glisson pedicle, the MHV was well exposed in 14 cases of new-fashion group and none of traditional group ( P<0.001). All the patients successfully completed the operation without conversion to laparotomy. Intraoperative blood loss, incidence of postoperative bile leakage, time of peritoneal drainage tube removal, postoperative hospital stay, AST, ALT, total bilirubin and albumin 3 days after surgery between the two groups were no significant differences (all P>0.05). Conclusion:LALH using the rapid division of left Glisson pedicle and Arantius tube plane in " one-clamp" fashion could be safe and feasible, the time of left Glisson pedicle and liver transection was short.
