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Chinese Journal of Hepatic Surgery(Electronic Edition) ›› 2018, Vol. 07 ›› Issue (06): 473-476. doi: 10.3877/cma.j.issn.2095-3232.2018.06.010

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Application of hemihepatic vascular occlusion through hilar plate in laparoscopic hemihepatectomy

Meisheng Li1, Jianyuan Hu1, Yingjun Chen1, Zuojun Zhen1,()   

  1. 1. Department of Hepatopancreatobiliary Surgery, the First People's Hospital of Foshan, Foshan 528000, China
  • Received:2018-09-27 Online:2018-12-10 Published:2018-12-10
  • Contact: Zuojun Zhen
  • About author:
    Corresponding author: Zhen Zuojun, Email:

Abstract:

Objective

To evaluate the clinical application value of hemihepatic vascular occlusion through hilar plate in laparoscopic hemihepatectomy.

Methods

Clinical data of 32 patients undergoing laparoscopic hemihepatectomy in the First People's Hospital of Foshan from September 2010 to December 2017 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among 32 patients, 20 cases were male and 12 were female, aged28-71 years with a median age of 46 years. Laparoscopic left hemihepatectomy was performed in 18 cases and laparoscopic right hemihepatectomy in 14 cases. Intraoperative and postoperative physical conditions were observed.

Results

30 cases successfully underwent hemihepatic vascular occlusion through hilar plate, 1 case was converted to intrathecal dissection of hepatic artery and portal vein due to local hepatic portal adhesion and 1 case was converted to open surgery due to hepatic portal hemorrhage induced by severe liver cirrhosis. During the process of liver resection, 4 cases were converted to open surgery due to massive hemorrhage. The average length of hemihepatic vascular occlusion through hilar plate was (12±5) min, the operation time was (176±52) min and the median intraoperative blood loss was 360 (50-1 400) ml. Postoperative bile leakage occurred in 9 cases, who were cured after adequate drainage. Liver trauma bleeding was observed in 1 case, who was cured after blood transfusion. Postoperative length of hospital stay was (7.1±2.6) d. No postoperative liver failure or perioperative death occurred.

Conclusions

Hemihepatic vascular occlusion through hilar plate is a feasible, efficacious, safe and reliable approach for hepatic blood flow occlusion, which can be applied in laparoscopic hemihepatectomy.

Key words: Laparoscopes, Hepatectomy, Blood occlusion, Hilar plate

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