Abstract:

Objective

To investigate the process optimization of laparoscopic anatomical mesohepatectomy for hepatocellular carcinoma （HCC）.

Methods

Clinical data of 16 HCC patients admitted to Guangdong Provincial Hospital of Chinese Medicine and Zhuhai Branch of Guangdong Provincial Hospital of Chinese Medicine from January 2019 to January 2023 were retrospectively analyzed.Among them，14 patients were male and 2 females， aged （57±10） years on average， body mass index （BMI） of（22±3） kg/m².15 patients were complicated with HBV infection， including 7 cases of cirrhosis.The ICGR15 was calculated as 0.060±0.024， the number of tumors was （1.8±0.7）， the maximal diameter of tumors was （6.8±1.9） cm， and the residual liver volume accounted for （59.0±9.1）%.Anatomical liver surface markers were made， intraoperative ultrasound was used for localization，the route of liver parenchyma mesohepatectomy was prioritized and surgical process was optimized.Laparoscopic anatomical mesohepatectomy was performed.Perioperative status， complications and efficacy were observed.

Results

16 patients successfully underwent the surgery， and none was converted to open surgery.The operation time was （212±61） min， intraoperative blood loss was （191±125） ml， the time of hepatic portal occlusion was （46±9） min and hepatic surgical margin was （13±5） mm.Mild postoperative bile leakage occurred in 1 case， which was cured by conservative treatment.No severe complications such as bleeding， liver failure and infection or death were reported.The length of postoperative hospital stay was （10.9±2.2） d.Postoperative follow-up time was ranged from 8.0 to 34.0 months， and the median follow-up time was 22.6 months.During postoperative follow-up， 2 cases recurred and no death occurred.

Conclusions

Under the premise of mastering the highlights of laparoscopic hepatectomy， optimized laparoscopic mesohepatectomy is a convenient， safe and feasible treatment for HCC.

Key words: Laparoscopes, Hepatectormy, Middle lobe, Carcinoma, hepatocellular