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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
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Laparoscopic central hepatectomy using a parenchymal-first approach: how we do it.
Zhipeng Zheng1,2, Haorong Xie2, Zhangyuanzhu Liu2
1Division of Hepatobiliopancreatic Surgery, Department of General Surgery, Nanfang Hospital, Southern Medical University, No.1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China.
Surgical Endoscopy
|September 15, 2022
Summary
Laparoscopic central hepatectomy (LCH) is challenging. A parenchymal-first approach proved feasible and safe in 19 patients with hepatocellular carcinoma, showing low morbidity and no mortality.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic central hepatectomy (LCH) presents significant technical challenges.
- This study focuses on the parenchymal-first approach for LCH.
Purpose of the Study:
- To describe the institutional experience with LCH using a parenchymal-first strategy.
- To analyze the feasibility, safety, and outcomes of this approach.
Main Methods:
- Retrospective analysis of 19 consecutive LCH patients (July 2017-June 2021).
- Focus on a parenchymal-first surgical technique.
- Data collection included demographics, operative details, and postoperative outcomes.
Main Results:
- All 19 patients had hepatocellular carcinoma without major vascular invasion.
- No conversions to open surgery or intraoperative blood transfusions were required.
- Low postoperative morbidity (15.8%) with no bleeding, hepatic failure, or mortality; average hospital stay was 10 days.
Conclusions:
- The parenchymal-first approach is a feasible and optimized strategy for LCH.
- This technique may offer advantages in laparoscopic anatomical hepatectomy.
