دورية أكاديمية

Caudo-dorsal approach combined with the occlusion of right hepatic vein and Pringle maneuver in laparoscopic anatomical resection of segment 7.

التفاصيل البيبلوغرافية
العنوان: Caudo-dorsal approach combined with the occlusion of right hepatic vein and Pringle maneuver in laparoscopic anatomical resection of segment 7.
المؤلفون: Yang, Wugui, Peng, Yufu, Yang, Yubo, Liang, Bin, Li, Bo, Wei, Yonggang, Liu, Fei
المصدر: Surgical Endoscopy & Other Interventional Techniques; Jun2024, Vol. 38 Issue 6, p3455-3460, 6p
مصطلحات موضوعية: MORTALITY prevention, LIVER histology, LIVER surgery, BODY mass index, RESEARCH funding, HEPATIC veins, LAPAROSCOPIC surgery, SEX distribution, TREATMENT effectiveness, DESCRIPTIVE statistics, TREATMENT duration, AGE distribution, SURGICAL blood loss, LIVER diseases, SURGICAL complications, COMBINED modality therapy, BILE duct adenocarcinoma, CARBON dioxide, GAS embolism, LENGTH of stay in hospitals, HEPATOCELLULAR carcinoma
مستخلص: Background: Laparoscopic anatomical resection of segment 7 (LARS7) remains a technically challenging procedure due to the deep anatomical location and the potential risk of injury to the right hepatic vein (RHV). Herein, we initiated an innovative technique of caudo-dorsal approach combined with the occlusion of the RHV and Pringle maneuver for LARS7 and presented the outcomes of our initial series. Method: Since January 2021, the patients who underwent LARS7 by using this novel technique were enrolled in this study. The critical aspect of this technique was the interruption of communication between the RHV and the inferior vena cava. Meanwhile, the Pringle maneuver was adopted to control the hepatic inflow. Result: A total of 11 patients underwent LARS7 by using this novel technique, which included 8 hepatocellular carcinoma, 2 bile duct adenocarcinoma and one focal nodular hyperplasia. The median operative time was 199 min (range of 151–318 min) and the median blood loss was 150 ml (range of 50–200 ml). The main trunk of the RHV was fully exposed on the cutting surface in all cases and no patient received perioperative blood transfusion. No procedure was converted to open surgery. Of note, no indications of CO2 gas embolism were observed in these cases after the introduction of double occlusion. Only one patient suffered from postoperative complications and healed after treatment. The median postoperative stay was 5 days (range of 4–7 days). The 90-day mortality was nil. At a median follow-up period of 19 months, all of the patients were alive without any evidence of tumor recurrence. Conclusion: The caudo-dorsal approach combined with the occlusion of RHV and the Pringle maneuver may be a feasible and expected technique for safe exposure of RHV in LARS7. Further validation of the feasibility and efficacy of this technique is needed. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:18666817
DOI:10.1007/s00464-024-10908-6