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find Keyword "Vascular control" 1 results
  • Application of Hepatic Vascular Control in Laparoscopic Hepatectomy

    Objective To investigate the technique and feasibility of hepatic pedicle vascular control in laparoscopic hepatectomy. Methods From May 2005 to June 2011, 95 cases of hepatectomies were performed by laparoscopy in the Department of Minimally Invasive Surgery, The First Affiliated Hospital, Guangxi Medical University.The characteristics of these cases were analyzed. Results Left lateral segmentectomy were required in 21 patients, left hepatectomy in 13 patients, right hepatectomy in 4 patients, segmentectomy in 17 patients, tumor resection in 24 patients,hemangioma resection in 5 patients, and conversions to laparotomy in 11 patients. The intermittent Pringle maneuver were performed in 39 patients. The mean vascular clamping time in Pringle maneuver was (30.84±9.51) min. The selective vascular control of inflow were performed in 56 patients, the technique included intrahepatic Glisson approach in 14 patients and controlling hepatic artery and portal vein separately in 42 patients. Pre-parenchymal transection control of hepatic outflow were performed in 12 patients, included the left hepatic vein were controlled by suturing or separating in 11 patients and right hepatic vein was controlled by separating in 1 patient. Others were controlled intraparenchymally during transection. The mean operative time was (236.80±95.97) min,mean operative blood loss was( 551.55±497.41) ml, concentrate red blood cells transfusion volume was( 2.60±2.23) U, and plasma transfusion volume was (211.90±179.29) ml. The postoperative complications included bleeding in 4 patients, pleural effusion in 4 patients, pneumonia in 3 patients, ascites in 7 patients, and biliary fistula in 2 patients, and dead in 1 patient. The mean hospitalization time was( 12.47±4.18) days. At the deadline( February 2012), 72 cases with liver cancer were followup. The follow-up time ranged from 5 to 81 months and the mean time was( 24.14±16.62) months, where survival rate was 68.4%( 54/79) of 1-year and 21.5%( 17/79) of 3-year. Conclusions The application of hepatic pedicle vascular control in laparoscopic hepatectomy is feasible.

    Release date:2016-09-08 10:38 Export PDF Favorites Scan
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