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.

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.

[Objective]To Probe the causes of significant operatiive complications of ossification of posterior longitudinal ligament as well as the treatment outcomes in order to reduce the surgical morbidities and to suggest preventive measures of complications.[Method]The surgical data of 85 cases with ossification of posterior longitudinal ligament were reviewed form March 2002 to May 2006.In continuous long segment OPLL which were treated by bilaminectomy with internal fixation system;short segment OPLL which were treated by corpectomy of anterior cervical approach with bone of autograft and anterior cervical spine locking plates.[Result]Totally 66 cases were followed-up from 3 to 25 months with an average of 13 months.Complication of posteior cervical approach:8 cases with the pain of neck-shoulder,which resulted from postoperative radiculopathy and nerve root irritation or injury.Most of 8 cases were recovered in 2 to 20 weeks by conservative treatment such as antalgica,dehydration and physiotherapy.Four cases with quadriparesis or symptom deteriorate,which resulted from reperfusion injury of spine cord.Two cases were recovered by hyperbaric oxygen and medication and 1 cases recovered not enough.Two cases with posterior cervical hemotoma were caused by bleeding of smaller blood vessels and obstruction of drainage.One case of CSF leakage were cured in 3 days with cervical spinal immobilization and moderate local compressiom.Two cases of local infection were cured during 20 days with antibiotics or combined with debridement and suturing.Complications of anterior cervical approach:a cases with quadriparesis or symptom deteriorate;1 case of CSF leakage.Complications related to instruments included 1 case of titanium net subsidence and 1 case of single lateral mass screw back-out.[Conclusion]Many kinds of operative complications could occur in either anterior or posterior approach of surgery of ossification of posterior longitudinal ligament.Preoperative good preparation,intraoperative carefull operation and postoperative strengthened management are the key points to decrease and prevent operative related complications.