To investigate the application value of two-step method with Endo-GIA in laparoscopic left hepatectomy.

Clinical data of 21 patients who underwent laparoscopic left hepatectomy using two-step method with Endo-GIA in the First People's Hospital of Foshan between September 2013 and July 2016 were retrospectively analyzed. Among them, 15 cases were males and 6 females, aged 45-67 years old with a median age of 55 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The patients received general anesthesia by endotracheal intubation. The liver capsula was incised by electro-scalpel, the liver was resected by harmonic scalpel and the hemostasis was performed by laparoscopic bipolar coagulation. The hepatic parenchyma was incised along the lower margin of the liver. When the incising plane approached the first and second porta hepatis, the left liver pedicle and partial posterior liver tissues, residual liver tissues and left hepatic vein were occluded and cut by Endo-GIA. The intraoperative and postoperative conditions of the patients were observed.

The operation was successfully performed in all patients. No patient was switched to open surgery. The mean operation time was (212±68) min. The intraoperative blood loss was (269±74) ml. No intraoperative blood transfusion was observed. The postoperative length of hospital stay was (13±4) d. Postoperative complications of bile leakage were observed in 2 cases, and were cured after conservative therapy.

Laparoscopic left hepatectomy using two-step method with Endo-GIA has the advantages of simple, convenient, safe and high success rate, which offers a novel surgical option for clinical practice.