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Laparoscopic anatomical S5 segmentectomy by the Glissonian approach
Keun Soo Ahn1, Ho-Seong Han, Yoo-Seok Yoon
1Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea.
Summary
This study demonstrates the feasibility of laparoscopic anatomical segment 5 (S5) liver resection using the glissonian approach for malignant liver tumors. This minimally invasive technique offers a viable alternative for complex liver surgeries.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgical techniques
- Surgical oncology
Background:
- Nonanatomical tumorectomy is common for liver segment 5 (S5) malignant tumors.
- Anatomical S5 segmentectomy is technically challenging, especially laparoscopically.
- The glissonian approach offers a potential solution for laparoscopic S5 segmentectomy.
Observation:
- A 53-year-old male presented with an incidentally found hepatic mass in S5.
- Preoperative imaging revealed a 5.2-cm mass suspicious for hepatocellular carcinoma.
- The patient had normal liver function (Child-Pugh class A).
Findings:
- Laparoscopic anatomical S5 segmentectomy was successfully performed using the glissonian approach.
- The procedure took 300 minutes with an estimated blood loss of 300 mL.
- Postoperative pathology confirmed a neuroendocrine carcinoma with cholangiocarcinoma components; the patient recovered without complications.
Implications:
- This case highlights the feasibility and safety of laparoscopic anatomical S5 segmentectomy.
- The glissonian approach may facilitate complex laparoscopic liver resections.
- This technique could expand minimally invasive options for S5 liver tumors.
