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Standardized Approach for Laparoscopic Hemispheric Liver Resection for Segments 7 and 8
Ryoichi Miyamoto1, Masahiro Shiihara1, Mitsuru Watanabe1
1Department of Gastroenterological Surgery, Ibaraki Medical Center Tokyo Medical University Ibaraki Japan.
Background:
We investigated whether the standardized "can-opener method" surgical technique is an adequate surgical procedure for hemispheric hepatectomy in segments 7 and 8.
Methods:
Forty-two patients who underwent laparoscopic hemispheric liver resection for segments 7 and 8 using our standardized surgical technique were enrolled. To examine the effect of this standardized surgical procedure on short-term outcomes, patients were classified into two groups based on the timing of the standardization of their procedures (Group A, the first half of the cases, and Group B, the second half of the cases). Short-term outcomes were subsequently compared between the two groups.
Results:
Significant differences in operation time (465 min vs. 332 min, p = 0.001), intraoperative blood loss volume (645 g vs. 105 g, p = 0.011), postoperative complications (Clavien‒Dindo Grade I and Grade II) (7 vs. 1, p = 0.011), and length of postoperative hospital stay (10 days vs. 7 days, p = 0.001) were detected between the two groups. All patients had negative surgical margins. With respect to postoperative complications, four patients had Grade I complications, such as wound infection and minor pneumonia, and four patients had Grade II complications, such as bile duct infection and intra-abdominal abscess. No patients experienced 90-day mortality.
Conclusion:
Our standardized surgical technique is an adequate surgical procedure for hemispheric hepatectomy in segments 7 and 8 and is referred to as the "can-opener method".
