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Updated: Jun 30, 2026
Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
[Resection of centrally located primary liver cancer]
Chao-liu Dai1, Song-lin Peng, Chang-jun Jia
1Department of Hepatobiliary Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, China. daicl@cmu2h.com
Objective:
To summarize the experience of hepatectomy for patients with centrally located primary liver cancer.
Methods:
The clinical data of patients with centrally and non-centrally located primary liver cancer were retrospectively reviewed. The biochemical indicators, operation duration, hepatic inflow occlusion time, hospital stay, operative blood loss, amount of blood transfusion, complication, and effectiveness of three occlusion methods (semi-hepatic inflow occlusion, Pringle's manoeuvre, and modified Pringle's manoeuvre) were analyzed.
Results:
Tumor diameter, Child-Pugh score, indocyanine green retention rate, aspartate aminotransferase, alanine aminotransferase, glutamyltransferase, total bilirubin, direct bilirubin, albumin, prealbumin, cholinesterase, hepatic inflow occlusion time, blood transfusion, postoperative complications, and operative blood loss were not significantly different between patients with centrally and non-centrally located primary liver cancer. Patients with centrally located liver cancer had significantly longer operation duration and hospital stay than patients with non-centrally located liver cancer (P < 0.05). The modified Pringle's manoeuvre of hepatic inflow occlusion had the same effectiveness of the Pringle's manoeuvre and could be performed in a simpler way.
Conclusions:
Hepatectomy is safe and feasible for patients with centrally located primary liver cancer. Appropriate preoperative evaluation and preparation, sufficient knowledge of liver anatomy, and proper selection of hepatic inflow occlusion method are key factors to guarantee the success of the resection.
