Laparoscopic left hemihepatectomy guided by indocyanine green fluorescence: A cranial-dorsal approach
作者机构:Institute of Hepatobiliary SurgeryFirst Affiliated HospitalArmy Medical UniversityChongqing 400038China Department of Hepatobiliary SurgeryQujing Central Hospital of Yunnan Regional Medical CenterQujing 655000Yunnan ProvinceChina School of Clinical MedicineQujing Medical CollegeQujing 655000Yunnan ProvinceChina
出 版 物:《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志(英文版)(电子版))
年 卷 期:2024年第16卷第2期
页 面:409-418页
核心收录:
学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
基 金:Supported by The High-level Talent Training Support Project of Yunnan Province,No.YNWR-MY-2020-053 and the Key Project of the Second People's Hospital of Qujing in 2022,No.2022ynkt04
主 题:Laparoscopic left hemihepatectomy Indocyanine green Cranial-dorsal approach Laparoscopic hepatectomy Arantius ligament Glissonean pedicle
摘 要:BACKGROUND Advancements in laparoscopic technology and a deeper understanding of intra-hepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy(LH)*** indocyanine green(ICG)fluorescence navi-gation technique has emerged as the most effective method for identifying hepatic regions,potentially overcoming the limitations of *** laparoscopic left hemihepatectomy(LLH)is a standardized procedure,there is a need for innova-tive strategies to enhance its *** anatomical markers,surgical skills,and ICG staining *** Thirty-seven patients who underwent ICG fluorescence-guided LLH at Qujing Second People s Hospital between January 2019 and February 2022 were retrospectively *** cranial-dorsal approach was performed which involves dissecting the left hepatic vein cephalad,isolating the Arantius ligament,exposing the middle hepatic vein,and dissecting the parenchyma from the dorsal to the foot in order to complete the anatomical *** surgical methods,as well as intra-and post-surgical data,were recorded and *** hospital’s Medical Ethics Committee approved this study(Ethical review:2022-019-01).RESULTS Intraoperative blood loss during LLH was 335.68±99.869 mL and the rates of transfusion and conversion to laparotomy were 13.5%and 0%,*** overall incidence of complications throughout the follow-up(median of 18 months;range 1-36 months)was 21.6%.No mortality or severe complications(level IV)were *** LLH has the potential to become a novel,standardized approach that can effectively,safely,and simply expose the middle hepatic vein and meet the requirements of precision surgery.