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laparoscopic hepatectomy is superior to open procedures for hepatic hemangioma

Hepatobiliary & Pancreatic Diseases International 2021年第2期20卷 142-146页

作者： Chen Yan Bing-Hua Li Xi-Tai Sun De-Cai Yu Department of Hepatobiliary Surgery Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008China Department of General Surgery Taikang Xianlin Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210046China

Background:laparoscopic hepatectomy(LH)has become increasingly popular for liver neoplasms,but its safety and effectiveness remain *** hemangiomas are the most common benign liver neoplasm;the main approaches to hepatic hemangiomas include open hepatectomy(OH)and *** this study,we compared early outcomes between patients undergoing OH and those with ***:Patients underwent OH or LH in our hospital for hepatic hemangiomas between December 2013 and December 2017 were *** patients underwent comprehensive preoperative *** clinicopathological index and risk factors of hemangioma resection were ***:In total,41 patients underwent OH while 53 underwent *** was no significant difference in any preoperative clinical variables,including liver function,prothrombin time,or platelet *** portal occlusion time and operative time were 39.74 vs.38.35 minutes(P=0.717)and 197.20 vs.203.68 minutes(P=0.652)in the OH and LH groups,*** mortality nor significant perioperative complications were observed between the two *** LH group,two cases were converted to OH,one for an oversized tumor and the other for *** with OH patients,those with LH had less blood loss(361.69 vs.437.81 m L,P=0.024),shorter postoperative hospital stay(7.98 vs.11.07 days,P=0.001),and lower postoperative C-reactive protein(43.63 vs.58.21 mg/L,P=0.026).Conclusions:LH is superior to OH in terms of postoperative recovery and blood loss for selected patients with hepatic hemangioma.

关键词： Hepatic hemangioma Open hepatectomy laparoscopic hepatectomy Prognosis

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laparoscopic hepatectomy reduces postoperative complications and hospital stay in overweight and obese patients

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World Journal of Gastrointestinal Surgery 2021年第1期13卷 19-29页

作者： Daniel Heise Jan Bednarsch Andreas Kroh Sandra Schipper Roman Eickhoff Marielle Coolsen Ronald Van Dam Sven Lang Ulf Neumann Florian Ulmer Department of Surgery and Transplantation University Hospital RWTH AachenAachen 52074Germany Department of Surgery Maastricht University Medical CenterMaastricht 6229 HXNetherlands

BACKGROUND laparoscopic liver surgery is currently considered the standard of care for various liver ***,studies focusing on perioperative outcome after laparoscopic hepatectomy(LH)in overweight patients are still sparse and its benefit compared to open hepatectomy(OH)is a matter of *** To analyze postoperative outcomes in overweight[body mass index(BMI)over 25 kg/m²]and obese(BMI over 30 kg/m²)patients undergoing LH and compare postoperative outcome with patients undergoing *** Perioperative data of 68 overweight(BMI over 25 kg/m²)including a subcohort of obese(BMI over 30 kg/m²)patients(n=27)who underwent LH at our institution between 2015 and 2019 were retrospectively analyzed regarding surgical outcome and compared to an equal number of patients undergoing *** The mean BMI was 29.8±4.9 kg/m2 in the LH group and 29.7±3.6 kg/m2 in the OH group with major resections performed in 20.6%(LH)and 26.5%(OH)of cases,*** time(194±88 min vs 275±131 min;P<0.001)as well as intensive care(0.8±0.7 d vs 1.1±0.8 d;P=0.031)and hospital stay(7.3±3.6 d vs 15.7±13.5 d;P<0.001)were significant shorter in the LH ***,overall complications(20.6%vs 45.6%;P=0.005)and major complications(1.5%vs 14.7%,P=0.002)were observed less frequently after *** additional investigation analyzing the subgroup of obese patients who underwent LH(n=27)and OH(n=29)showed a shorter operative time(194±81 min vs 260±137 min;P=0.009)and a reduced length of hospitalization(7.7±4.3 d vs 17.2±17 d;P<0.001)but no difference in postoperative complications or overall *** LH is safe and cost-effective in overweight and obese ***,LH is significantly associated with fewer postoperative complications and reduced hospital stay compared to OH in these patients.

关键词： laparoscopic hepatectomy Obesity Overweight Morbidity Postoperative outcome Cost

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Is laparoscopic hepatectomy superior to open hepatectomy for hepatocellular carcinoma?

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World Journal of Hepatology 2017年第4期9卷 167-170页

作者： Jian-Hong Zhong Ning-Fu Peng Jian-Hong Gu Ming-Hua Zheng Le-Qun Li Department of Hepatobiliary Surgery Affiliated Tumor Hospital of Guangxi Medical University Yangzhou University and Jiangsu Co-Innovation Center Department of Hepatology Liver Research Center the First Affiliated Hospital of Wenzhou Medical University

The low perioperative morbidity and shorter hospital stay associated with laparoscopic hepatectomy have made it an often-used option at many liver centers, despite the fact that many patients with hepatocellular carcinoma have cirrhosis, which makes the procedure more difficult and dangerous. Type of surgical procedure proves not to be a primary risk factor for poor outcomes after hepatic resection for hepatocellular carcinoma, the available evidence clearly shows that laparoscopic hepatectomy is an effective alternative to the open procedure for patients with early-stage hepatocellular carcinoma, even in the presence of cirrhosis. Whether the same is true for patients with intermediate or advanced disease is less clear, since laparoscopic major hepatectomy remains a technically demanding procedure.

关键词： Hepatocellular carcinoma laparoscopic hepatectomy Open hepatectomy

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A nomogram predicting the recurrence of hepatocellular carcinoma in patients after laparoscopic hepatectomy

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Cancer Communications 2019年第1期39卷 499-509页

作者： Yang-Xun Pan Jian-Cong Chen Ai-Ping Fang Xiao-Hui Wang Jin-Bin Chen Jun-Cheng Wang Wei He Yi-Zhen Fu Li Xu Min-Shan Chen Yao-Jun Zhang Qi-Jiong Li Zhong-Guo Zhou State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineSun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Liver Surgery Sun Yat-sen University Cancer Center651 Dongfeng Road EastGuangzhou 510060GuangdongP.R.China Department of Public Health Sun Yat-sen UniversityGuangzhou 510080GuangdongP.R.China Department of Molecular Medicine California Campus The Scripps Research Institute10550North Torrey Pines RoadLa JollaCA 92037USA

Background:Patients with hepatocellular carcinoma(HCC)undergoing surgical resection still have a high 5-year recurrence rate(~60%).With the development of laparoscopic hepatectomy(LH),few studies have compared the efficacy between LH and traditional surgical approach on *** objective of this study was to establish a nomo-gram to evaluate the risk of recurrence in HCC patients who underwent ***:The clinical data of 432 patients,pathologically diagnosed with HCC,underwent LH as initial treatment and had surgical margin>1 cm were *** significance of their clinicopathological features to recurrence-free survival(RFS)was assessed,based on which a nomogram was constructed using a training cohort(n=324)and was internally validated using a temporal validation cohort(n=108).Results:Hepatitis B surface antigen(hazard ratio[HR],1.838;P=0.044),tumor number(HR,1.774;P=0.003),tumor thrombus(HR,2.356;P=0.003),cancer cell differentiation(HR,0.745;P=0.080),and microvascular tumor invasion(HR,1.673;P=0.007)were found to be independent risk factors for RFS in the training cohort,and were used for con-structing the *** C-index for RFS prediction in the training cohort using the nomogram was 0.786,which was higher than that of the 8th edition of the American Joint Committee on Cancer TNM classification(C-index,0.698)and the Barcelona Clinic Liver Cancer staging system(C-index,0.632).A high consistency between the nomogram prediction and actual observation was also demonstrated by a calibration *** improved predictive benefit in RFS and higher threshold probability of the nomogram were determined by receiver operating characteristic curve analysis,which was also confirmed in the validation cohort compared to other ***:We constructed and validated a nomogram able to quantify the risk of recurrence after initial LH for HCC patients,which can be clinically implemented in assisting the planification of individual postoperative surveil-lance

关键词： Hepatocellular carcinoma laparoscopic hepatectomy Recurrence Nomogram American Joint Committee on Cancer TNM classification Barcelona Clinic Liver Cancer staging system Hepatitis B surface antigen Tumor thrombus Tumor invasion

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Successful outcome of massive carbon dioxide embolism during laparoscopic hepatectomy

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laparoscopic, Endoscopic and Robotic Surgery 2020年第2期3卷 52-55页

作者： Jun Zhang Jie Zhao Yue Fei Tieshuai Liu Minjun Liu Department of Anesthesiology Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Department of General Surgery Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Department of Nursing Education Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China

Carbon dioxide embolism is a rare but severe complication of laparoscopic *** reported a case of massive carbon dioxide embolism that developed into a rare paradoxical gas embolism during laparoscopic hepatectomy and resulted in reduced muscular power of the left upper extremity,severe pleural effusion and hypoalbuminemia after ***,the patient fully recovered with positive prevention and postoperative *** case report highlights that the surgeon and anaesthesiologist must be aware of the risks and the importance for prompt treatment when massive carbon dioxide embolism occurs.

关键词： CO2 embolism Paradoxical CO2 embolism laparoscopic hepatectomy Pulmonary oedema

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Transumbilical single-incision laparoscopic hepatectomy： an initial report

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Chinese Medical Journal 2011年第5期124卷 787-789页

作者： HU Ming-gen ZHAO Guo-dong XU Da-bing LIU Rong Department of Hepatobiliary Surgery Chinese People's Liberation Army General Hospital Beijing 100853 China

Transumbilical single-incision laparoscopic surgeries have attracted the attention of surgeon. Here we report a patient with multiple hepatic hemagiomas and symptomatic cholelithiasis who underwent laparoscopic left lateral hepatecomy and left hepatic hemangioma enucleation with single incision followed by cholecystectomy. The duration of the operation was 155 minutes and the blood loss was 100 ml. There were no complications during or after the treatment. This surgical treatment yields a good cosmetic effect and rapid recovery.

关键词： transumbilical single-incision laparoscopic surgery natural orifice endoscopic surgery laparoscopic hepatectomy

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Comparison of laparoscopic hepatectomy,percutaneous radiofrequency ablation and open hepatectomy in the treatment of small hepatocellular carcinoma

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2016年第3期17卷 236-246页

作者： Chong LAI Ren-an JIN Xiao LIANG Xiu-jun CAI Department of Surgery Institute of Minimally lnvasive Surgery Sir Run Run Shaw Hospital School of Medicine Zhejiang University Hangzhou 310016 China Department of Surgery the First Affiliated Hospital School of Medicine Zhejiang University Hangzhou 310003 China

Objective： Three mainstream techniques-laparoscopic hepatectomy （LH）, percutaneous radiofrequency ablation （pRFA）, and open hepatectomy （OH）--were compared in this study, in terms of their efficacies in the treat- ment of small hepatocellular carcinoma （HCC）. Methods： A comparative study was performed within a total of 94 patients diagnosed with small HCC in our hospital from 2005 to 2010, who underwent LH （28）, RFA （33）, or OH （33）. They had either a single tumor lesion of less than 5 cm or up to three nodules with diameters of less than 3 cm each. Outcomes were carefully evaluated throughout a 3-year follow-up interval and statistically interpreted. Results： The pRFA group had a significantly lower disease-free survival rate compared with the two surgical groups （P=0.001） and significantly shorter overall survival （P=-0.005）, while the LH group and the OH group had no difference in survival results. For patients younger than 60 years old, surgical approaches offered a better long-term overall survival prognosis （P=0.008）. There were no statistically significant differences among the three groups in overall survival for elderly patients （P=0.104）. Conclusions： Among patients with small HCC, LH may provide better curative effects than pRFA without increasing complication rates, pRFA leads to faster recurrence than surgical resections. LH has similar therapeutic effects to OH and causes less trauma. For patients younger than 60 years old, LH may be the best curative treatment. Elderly patients may choose either surgery or pRFA.

关键词： Hepatocellular carcinoma laparoscopic hepatectomy Minimally invasive techniques Open hepatectomy Percutaneous radiofrequency ablation

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laparoscopic VS open hepatectomy for hepatolithiasis: An updated systematic review and meta-analysis

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World Journal of Gastroenterology 2017年第43期23卷 7791-7806页

作者： Hui Li Jun Zheng Jian-Ye Cai Shi-Hui Li Jun-Bin Zhang Xiao-Ming Wang Gui-Hua Chen Yang Yang Gen-Shu Wang Department of Hepatic Surgery and Liver Transplantation Center of the Third Affiliated Hospital Organ Transplantation InstituteSun Yat-sen UniversityOrgan Transplantation Research Center of Guangdong Province Guangdong Key Laboratory of Liver Disease Research Key Laboratory of Liver Disease Biotherapy and Translational Medicine of Guangdong Higher Education Institutesthe Third Affiliated Hospital of Sun Yat-sen University Department of Hepatobiliary Surgery Yijishan Hospital affiliated to Wannan Medical College

AIM To perform a meta-analysis on laparoscopic hepatectomy VS conventional liver resection for treating *** We conducted a systematic literature search on Pub Med,Embase,Web of Science and Cochrane Library,and undertook a meta-analysis to compare the efficacy and safety of laparoscopic hepatectomy V S conventional open liver resection for local hepatolithiasis in the left or right lobe. Intraoperative and postoperative outcomes(time,estimated blood loss,blood transfusion rate,postoperative intestinal function recovery time,length of hospital stay,postoperative complication rate,initial residual stone,final residual stone and stone recurrence) were analyzed *** A comprehensive literature search retrieved 16 publications with a total of 1329 cases. Meta-analysis of these studies showed that the laparoscopic approach for hepatolithiasis was associated with significantly less intraoperative estimated blood loss [weighted mean difference(WMD): 61.56,95% confidence interval(CI): 14.91-108.20,P = 0.01],lower blood transfusion rate [odds ratio(OR): 0.41,95%CI: 0.22-0.79,P = 0.008],shorter intestinal function recovery time(WMD: 0.98,95%CI: 0.47-1.48,P = 0.01),lower total postoperative complication rate(OR: 0.52,95%CI: 0.39-0.70,P laparoscopic approach for hepatolithiasis in the left lateral lobe and left side could achieve satisfactory therapeutic effects. CONCLUSION The laparoscopic approach is safe and effective,with less intraoperative estimated blood loss,fewer postoperative complications,reduced length of hospital stay and shorter intestinal funct

关键词： Hepatolithiasis laparoscopic hepatectomy Conventional liver resection Systematic review Metaanalysis

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laparoscopic vs open liver re-resection for cirrhotic patients with post-hepatectomy hepatocellular carcinoma recurrence:A comparative study

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World Journal of Gastrointestinal Surgery 2022年第5期14卷 409-418页

作者： Kai-Chi Cheng Kit-Man Ho Department of Surgery Kwong Wah HospitalHong Kong 999077China

BACKGROUND Repeated liver resection is an effective treatment for recurrent hepatocellular carcinoma(HCC).However,few studies have compared the outcome of laparoscopic repeat hepatectomy(LRH)and open repeat hepatectomy(ORH)for recurrent HCC,and few of those have included cirrhotic *** To compare short-term and long-term outcomes of cirrhotic patients with LRH and ORH for recurrent *** We retrospectively analysed the clinical records retrieved from a prospectively collected database of all patients who underwent hepatectomy for posthepatectomy recurrent HCC at our institute between May 2006 and June *** of recurrent HCCs larger than 7 cm were *** demographics,operative details,perioperative outcomes,pathologic details,disease-free survival(DFS),and overall survival(OS)data of LRH and ORH were *** Data from 29 patients with LRH and 22 with ORH were *** LRH group showed significantly better outcomes for blood loss(median 300 mL vs 750 mL,P=0.013)and length of hospital stay(median 5 d vs 7 d,P=0.003).The 1-,3-and 5-year OS rates in the LRH group were 100.0%,60.0%and 30.0%,respectively;the corresponding rates in the ORH group were 81.8%,36.4%and 18.2%(P=0.336).The 1-,3-and 5-year DFS rates in the LRH group were 68.2%,27.3%and 4.5%,respectively;the corresponding rates in the ORH group were 31.3%,6.3%and 6.3%(P=0.055).There were no significant differences in overall and DFS between the two *** laparoscopic re-resection should be considered for patients presenting with recurrent HCC less than or equal to 7 cm after previous hepatectomy.

关键词： Hepatocellular carcinoma Recurrence Repeat hepatectomy laparoscopic hepatectomy Outcome Overall survival Disease-free survival

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Functional anatomical hepatectomy guided by indocyanine green fluorescence imaging in patients with localized cholestasis:Report of four cases

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World Journal of Gastrointestinal Surgery 2021年第3期13卷 323-329页

作者： Hong-Wei Han Ning Shi Yi-Ping Zou Yuan-Peng Zhang Ye Lin Zi Yin Zhi-Xiang Jian Hao-Sheng Jin The Second School of Clinical Medicine Southern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of General Surgery Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhou 510080Guangdong ProvinceChina

BACKGROUND Liver cancer is a malignant tumor with a high *** present,the most effective treatment is laparoscopic hepatectomy(LH).Indocyanine green fluorescence imaging(ICG-FI)has become an important tool in LH,and the most common fluorescent types of tumors are total fluorescence,partial fluorescence,and rim *** SUMMARY We presented four cases of LH guided by ICG-FI in which we also observed the fourth special fluorescent *** the tumor or intrahepatic stone compresses the adjacent bile duct to cause local cholestasis,the liver segment or subsegment with obstructed bile drainage will show strong *** removal of the lesion together with the fluorescent liver parenchyma may help reduce the risk of tumor or stone *** This type of partial fluorescence can indicate local biliary compression,and the resection method is related to bile drainage,which may be called functional anatomical hepatectomy and ensures radical resection of the lesion.

关键词： Indocyanine green Localized cholestasis laparoscopic hepatectomy Unique fluorescent phenomenon Functional anatomical hepatectomy Case report

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