Clinical Utility of Glissonean Guided Approach for Laparoscopic Extended Posterior Sectionectomy
摘要
Minimally invasive anatomical hepatectomy is performed worldwide.
In total, 19 patients underwent laparoscopic extended posterior sectionectomy. Among them, 11 patients were treated using the HVGA, while 8 were treated using the GGA. The perioperative outcomes were compared between the two groups.
ResultsNo severe complications (Clavien–Dindo grade ≥ III) or in-hospital mortality occurred. Liver transection time was significantly shorter in the GGA group (p = 0.037), and blood loss was reduced (p = 0.033). The right hepatic vein (RHV) was divided in all cases. No significant differences were observed in IWATE criteria, postoperative hospital stay, or R0 resection rate, although the GGA group tended to have a higher R0 rate.
ConclusionsIn laparoscopic extended posterior sectionectomy, the GGA demonstrated favorable perioperative outcomes, with a significantly reduced liver transection time in comparison with HVGA. The GGA also tended to be associated with higher R0 resection rates, although the difference was not statistically significant. The GGA may be a valuable alternative technique for cases in which the HVGA is not feasible owing to tumor location and vascular invasion.