To investigate the safety and efficacy of hemihepatic vascular occlusion in laparoscopic resection of hepatocellular carcinoma (HCC).

Clinical data of 23 patients who underwent laparoscopic resection of HCC in the First People's Hospital of Foshan between January 2013 and December 2015 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the vascular occlusion method of the porta hepatis, the patients were divided into the hemihepatic vascular occlusion group (n=11) and Pringle group (n=12). In the hemihepatic vascular occlusion group, 9 cases were males and 2 females, aged 24-65 years old with a median age of 46 years old, and laparoscopic hemihepatic vascular occlusion via the portal plate was performed. In the Pringle group, 10 cases were males and 2 females, aged 31-66 years old with a median age of 43 years old, and laparoscopic vascular occlusion of the porta hepatis with Pringle maneuver was performed. The intraoperative and postoperative conditions and liver function changes in the perioperative period were observed in two groups. Liver function and length of hospital stay were compared between two groups using t test.

The ALT, TB and ALB levels at postoperative 7 d was respectively (58±12) U/L, (29±2) μmol/L, (38±3) g/L in the hemihepatic vascular occlusion group, and (80±24) U/L, (32±3) μmol/L, (34±4) g/L in the Pringle group, and significant differences were observed (t=-2.739, -2.192, 2.626; P<0.05). The postoperative length of hospital stay in the hemihepatic vascular occlusion group was (5.9±0.9) d, significantly shorter than (7.4±1.9) d in the Pringle group (t=-2.382, P<0.05). No patient was switched to open surgery, no death in the perioperative period was observed, and no liver failure, postoperative hemorrhage or other severe complications were observed in both groups.

Hemihepatic vascular occlusion is safe and feasible for laparoscopic resection of HCC. Compared with Pringle maneuver, it has the advantage of faster postoperative recovery. It is an ideal hepatic vascular occlusion method for laparoscopic hepatectomy.