To investigate the value of hilar plate detachment in laparoscopic anatomic right hepatectomy.

Clinical data of 28 patients with HCC who underwent laparoscopic anatomic right hepatectomy from July 2016 to October 2019 in the First People's Hospital of Foshan were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 22 patients were male and 6 female, aged 25-71 years and witha median of 59 years. Inflow blood occlusion via extra-Glissonean approach was performed with hilar plate detachment during the operation. Perioperative conditions, including duration of operation, intraoperative bleeding, postoperative hospital stay, postoperative 1, 3, 7 d liver function, and postoperative complications, were observed.

All patients underwent successful laparoscopic anatomic right hepatectomy without conversion to open surgery and no perioperative death occurred. There were 16 cases of right hepatectomy,3 cases of right anterior lobe resection and 9 cases of right posterior lobe resection. The median intraoperative bleeding was 425(300-775) ml, the mean duration of operation was (358±72) min, and postoperative hospital stay was (11±3) d. No postoperative bleeding or incision infection was observed. 21 cases suffered from mild right-sided pleural effusion, and recovered after conservative treatments. 1 case suffered from bile leakage and recovered by unobstructed drainage. On postoperative 7 d, the patient's liver function returned to normal basically.

Hilar plate detachment in laparoscopic anatomic right hepatectomy is safe and feasible, which can simplify the operative procedures. Pre-occlusion of blood flow at the hepatic pedicle can provide guidance for precise anatomic right hepatectomy.