Fluorescent guided laparoscopic central hepatic tumor resection <i>via</i> anterior transhepatic approach_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YAO Libo , LI Yunfeng ,  YIN Xinmin , WU Yifei , ZHU Siwei , LIU Yi , LIAO Chunhong , CAI Rongyao , CAI Chengzhi

Department of Hepatobiliary and Pancreas Minimally Invasive Surgery, The First Affiliated Hospital of Hu’nan Normal University/Hunan Provincial People’s Hospital, Changsha 410005, P. R. China;

Corresponding?author：

YIN Xinmin, Email: 13319587618@163.com

Keywords：

central hepatic tumor; laparoscopic hepatectomy; division of median hepatic fissure; indocyanine green fluorescence navigation

DOI：

10.7507/1007-9424.202012079

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the safety and feasibility of fluorescent guided laparoscopic central hepatic tumor resection via anterior transhepatic approach. Method We retrospectively analyzed the clinical data of three patients who underwent fluorescent guided laparoscopic central hepatic tumor resection via anterior transhepatic approach in Department of Hepatobiliary and Pancreas Minimally Invasive Surgery of Hunan Provincial People’s Hospital from April 2017 to April 2020.Results All the three patients completed the operation pure laparoscopically. Pathology results showed one case of hepatocellular carcinoma and two cases of focal nodular hyperplasia, the tumor size range from 4–7 cm. The operation time was 240–320 min, and the blood loss was 150–500 mL. There was no intraoperative blood transfusion. The postoperative hospital stay was 10–30 days. Postoperative bile leakage occurred in one patient, which was cured by laparoscopic hepatectomy. Three patients were followed up for 8, 36, and 25 months, respectively, and all the patients survived and there was no tumor recurrence up to november 2020.Conclusions Laparoscopic resection of central hepatic tumor is difficult and risky. Anterior transhepatic approach can maximize the preservation of liver parenchyma. In hepatobiliary and pancreatic centers with high volume of laparoscopic hepatectomy, this method is safe and feasible after strict patient selection, accurate preoperative evaluation, and fine intraoperative skills. Indocyanine green fluorescence navigation technology is helpful to accurately locate tumor during operation.

Citation： YAO Libo, LI Yunfeng, YIN Xinmin, WU Yifei, ZHU Siwei, LIU Yi, LIAO Chunhong, CAI Rongyao, CAI Chengzhi. Fluorescent guided laparoscopic central hepatic tumor resection via anterior transhepatic approach. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(2): 141-145. doi: 10.7507/1007-9424.202012079 Copy

1.	Xiao Y, Li W, Wan H, et al. Central hepatectomy versus major hepatectomy for patients with centrally located hepatocellular carcinoma: A meta-analysis. Int J Surg, 2018, 52: 297-302.
2.	Yamamoto J, Kosuge T, Shimada K, et al. Anterior transhepatic approach for isolated resection of the caudate lobe of the liver. World J Surg, 1999, 23(1): 97-101.
3.	彭淑牖, 牟一平, 彭承宏. 肝尾葉切除術 26 例報告. 中華外科雜志, 1999, 37(1): 12.
4.	Yang JH, Gu J, Dong P, et al. Isolated complete caudate lobectomy for hepatic tumor of the anterior transhepatic approach: surgical approaches and perioperative outcomes. World J Surg Oncol, 2013, 11: 197.
5.	李云峰, 尹新民. 腹腔鏡解剖性肝切除手術主刀模式變遷及優化. 中華消化外科雜志, 2019, 18(5): 430-433.
6.	朱斯維, 劉勝, 吳舒, 等. 兩步分層法腹腔鏡半肝切除術的應用價值. 中華消化外科雜志, 2018, 17(5): 508-513.
7.	曾永毅, 羅柳平, 張翔. 全腹腔鏡特殊部位肝臟腫瘤切除應對策略. 中華腔鏡外科雜志 (電子版), 2016, 9(2): 83-85.
8.	朱斯維, 尹新民, 姚立波, 等. 腹腔鏡治療中央型肝腫瘤的探討 (附 40 例報告). 中華外科雜志, 2019, 57(7): 517-522.
9.	蔡柳新, 何石林, 魏芳強, 等. 腹腔鏡下肝正中裂劈開在復雜腹腔鏡肝切除術中的應用. 中華醫學雜志, 2016, 96(34): 2722-2725.
10.	中華醫學會數字醫學分會, 中國醫師協會肝癌專業委員會, 中國醫師協會臨床精準醫學專業委員會, 等. 復雜性肝臟腫瘤切除三維可視化精準診治指南 (2019 版). 南方醫科大學學報, 2020, 40(3): 297-307.
11.	Araki K, Conrad C, Ogiso S, et al. Intraoperative ultrasonography of laparoscopic hepatectomy: key technique for safe liver transection. J Am Coll Surg, 2014, 218(2): e37-e41.
12.	朱沭, 王單, 張萬廣, 等. 腹腔鏡超聲引導下注射吲哚菁綠肝段染色在解剖性肝切除術中的應用研究. 中華超聲影像學雜志, 2019, 28(8): 685-690.
13.	索曉鵬. 吲哚菁綠熒光導航用于腹腔鏡肝膽手術的研究進展. 中國微創外科雜志, 2020, 20(5): 455-458, 462.
14.	劉袁君, 吳泓, 曾勇, 等. 腔鏡超聲聯合熒光顯像在腹腔鏡肝切除術中的應用. 中國普外基礎與臨床雜志, 2020, 27(6): 662-665.
15.	蔣利, 吳泓. 腹腔鏡肝切除術的現狀與展望. 中國普外基礎與臨床雜志, 2020, 27(6): 657-661.

1. Xiao Y, Li W, Wan H, et al. Central hepatectomy versus major hepatectomy for patients with centrally located hepatocellular carcinoma: A meta-analysis. Int J Surg, 2018, 52: 297-302.
2. Yamamoto J, Kosuge T, Shimada K, et al. Anterior transhepatic approach for isolated resection of the caudate lobe of the liver. World J Surg, 1999, 23(1): 97-101.
3. 彭淑牖, 牟一平, 彭承宏. 肝尾葉切除術 26 例報告. 中華外科雜志, 1999, 37(1): 12.
4. Yang JH, Gu J, Dong P, et al. Isolated complete caudate lobectomy for hepatic tumor of the anterior transhepatic approach: surgical approaches and perioperative outcomes. World J Surg Oncol, 2013, 11: 197.
5. 李云峰, 尹新民. 腹腔鏡解剖性肝切除手術主刀模式變遷及優化. 中華消化外科雜志, 2019, 18(5): 430-433.
6. 朱斯維, 劉勝, 吳舒, 等. 兩步分層法腹腔鏡半肝切除術的應用價值. 中華消化外科雜志, 2018, 17(5): 508-513.
7. 曾永毅, 羅柳平, 張翔. 全腹腔鏡特殊部位肝臟腫瘤切除應對策略. 中華腔鏡外科雜志 (電子版), 2016, 9(2): 83-85.
8. 朱斯維, 尹新民, 姚立波, 等. 腹腔鏡治療中央型肝腫瘤的探討 (附 40 例報告). 中華外科雜志, 2019, 57(7): 517-522.
9. 蔡柳新, 何石林, 魏芳強, 等. 腹腔鏡下肝正中裂劈開在復雜腹腔鏡肝切除術中的應用. 中華醫學雜志, 2016, 96(34): 2722-2725.
10. 中華醫學會數字醫學分會, 中國醫師協會肝癌專業委員會, 中國醫師協會臨床精準醫學專業委員會, 等. 復雜性肝臟腫瘤切除三維可視化精準診治指南 (2019 版). 南方醫科大學學報, 2020, 40(3): 297-307.
11. Araki K, Conrad C, Ogiso S, et al. Intraoperative ultrasonography of laparoscopic hepatectomy: key technique for safe liver transection. J Am Coll Surg, 2014, 218(2): e37-e41.
12. 朱沭, 王單, 張萬廣, 等. 腹腔鏡超聲引導下注射吲哚菁綠肝段染色在解剖性肝切除術中的應用研究. 中華超聲影像學雜志, 2019, 28(8): 685-690.
13. 索曉鵬. 吲哚菁綠熒光導航用于腹腔鏡肝膽手術的研究進展. 中國微創外科雜志, 2020, 20(5): 455-458, 462.
14. 劉袁君, 吳泓, 曾勇, 等. 腔鏡超聲聯合熒光顯像在腹腔鏡肝切除術中的應用. 中國普外基礎與臨床雜志, 2020, 27(6): 662-665.
15. 蔣利, 吳泓. 腹腔鏡肝切除術的現狀與展望. 中國普外基礎與臨床雜志, 2020, 27(6): 657-661.

Previous Article
Chinese expert consensus on the uniportal video-assisted thoracoscopic surgery for lung cancer: An interpreation
Next Article
Some thoughts on immunotherapy for esophageal squamous cell carcinoma

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Fluorescent guided laparoscopic central hepatic tumor resection via anterior transhepatic approach

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content