Retrograde laparoscopic resection of left side of the liver: a safe and effective way
The safety and feasibility of retrograde laparoscopic resection of the left side of the liver.
Ninety-three laparoscopic left hepatic lobe cases were selected between August 2010 and August 2014 from our institution. A retrospective cohort study was performed between the antegrade partial hepatectomy group (47 cases; dissection from the first porta hepatis to the second) and the retrograde partial hepatectomy group (46 cases; dissection from the second porta hepatis to the first), to compare the length of time needed for resection, the amount of bleeding, post-operative time in the hospital, and the incidence of major complications, such as bile leakage, abdominal abscess, and post-hepatectomy hemorrhage.
All of the cases had a successful laparoscopic partial hepatectomy without the need for an intraoperative blood transfusion. Patients were able to ambulate on post-operative day 1 and tolerated a liquid diet on post-operative day 1 or 2. There were no statistical differences of post-operative hospital length of stay or incidence of major complications between the two groups. Both duration of resection and the amount of bleeding were less in the retrograde group than of those in the antegrade group, due to the lower incidence of hepatic vein injury in the retrograde group.
Occlusion of both the inflow and outflow hepatic vessels combined with retrograde hepatectomy from the second porta hepatis to the first, demonstrated less hemorrhage and lower incidence of hepatic veins injury during laparoscopic partial hepatectomy.
KeywordsLaparoscopic hepatectomy Retrograde hepatectomy Hepatic inflow system Clamp the hepatic vein
This study was financially supported by grants from the national natural Science Foundation of China (No. 81130007, No. 81270446 and No. 30801188), Key Program of international Cooperation of Science and Technology Department of Zhejiang Province, China (No. 2011C14028), natural Science Foundation of Zhejiang Province, China (No. Y2090443 and No. LY13H030001), Medicine and Health Science and Technology Plan projects in Zhejiang Province (2016KYA166), and The Open Fund of Pharmaceutical Priority Level 1 subject in Zhejiang Province (YKFJ004).
Compliance with ethical standards
Hai-Biao Wang, Yun Zhang, Yuan-Da Hu, Hai-Jiao Yu, Min-Xia He, Sheng Huang and Jian Yu have no conflict of interest or financial ties to disclose.
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