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Dorsal Approach Combined with In Situ Split for Laparoscopic Segment 7 Resection.
Yang, Chongwei; Zhang, Rixin; Zheng, Zhi; Zhu, Ling.
Afiliación
  • Yang C; Department of Hepatobiliary Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Zhang R; Department of Hepatobiliary Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Zheng Z; Department of Hepatobiliary Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 13907164203@163.com.
  • Zhu L; Department of Hepatobiliary Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 13971661611@139.com.
Ann Surg Oncol ; 2024 Aug 11.
Article en En | MEDLINE | ID: mdl-39128976
ABSTRACT

BACKGROUND:

Laparoscopic segment 7 resection has been a technically challenging procedure (Li et al. in J Gastrointest Surg 231084-1085, 2019). We introduce a dorsal approach with in situ split for laparoscopic segment 7 resection. PATIENT AND

METHODS:

The patient was a 26-year-old male diagnosed with hepatic focal nodular hyperplasia located in segment 7. The lesion, measuring approximately 6.7 cm × 5.7 cm, was close to the right caudate lobe. Firstly, the segment 7 pedicle was exposed through the Rouviere's groove combined with caudate lobe-first approach, followed by clipping to confirm demarcation. Peripheral parenchymal transection at the dorsal side started and the intersegmental vein between segments 6 and 7 was found. Dissection of this vein towards its root proceeded preferentially at the dorsal side. Then the segment 7 pedicle was cut off, followed by parenchymal transection toward the cranial side to find the trunk of the compressed right hepatic vein (RHV). It was further dissociated from the trunk to periphery, exposing and cutting off its branches draining segment 7. The remaining parenchyma at the cranioventral side was subsequently separated along the exposed RHV. Finally, the resection of segment 7 was accomplished by dividing the right perihepatic ligaments.

RESULTS:

The operative time was 395 min with the estimated blood loss of 500 ml. The patient did not receive perioperative blood transfusion. The patient was discharged on tenth postoperative day following suture removal without experiencing any postoperative bleeding, hepatic failure, or other complications.

CONCLUSION:

Dorsal approach combined with in situ split for laparoscopic segment 7 resection is feasible and has certain advantages (Cao et al. in Surg Endosc 35174-181, 2021; Liu et al. in Surg Oncol 38101575, 2021; Yang et al. in Surg Endosc 371334-1341, 2023). Further investigations are required due to some limitations.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos