Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3685-3693
Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3685
Laparoscopic anatomical SVIII resection via middle hepatic fissure approach: Caudal or cranio side
Jian-Xin Peng, Hui-Long Li, Qing Ye, Jia-Qiang Mo, Jian-Yi Wang, Zhang-Yuanzhu Liu, Jun-Ming He
Jian-Xin Peng, Hui-Long Li, Qing Ye, Jia-Qiang Mo, Jian-Yi Wang, Zhang-Yuanzhu Liu, Jun-Ming He, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Author contributions: Peng JX and He JM conceived and designed the project; Ye Q, Mo JQ, and Wang JY collected the data; Liu ZY painted the figure; Li HL analyzed and interpreted the data and drafted the manuscript. All authors read and approved the final manuscript.
Supported by Guangdong Provincial Science and Technology Plan Project, No. 2022A0505050065; and Guangdong Natural Science Foundation, No. 2022A1515011632.
Institutional review board statement: This study was conducted according to the Helsinki Declaration, institutional review board approval was obtained from our hospital for this study, approval No. ZE2024-282-01.
Informed consent statement: All patients involved in this study provided informed consent and written informed consent was obtained.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The authors confirm that the data supporting the findings of this study are available within the article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Ming He, MD, Doctor, Professor, Surgeon, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Guangzhou 510120, Guangdong Province, China. hejunming0101@sina.com
Received: April 8, 2024
Revised: June 18, 2024
Accepted: August 27, 2024
Published online: December 27, 2024
Processing time: 232 Days and 20.1 Hours
Abstract
BACKGROUND

Laparoscopic hepatectomy is a proven safe and technically feasible approach for liver tumor resection, but laparoscopic anatomical SVIII resection (LASVIIIR) remains rarely reported due to poor accessibility, difficult exposure, and the deep-lying Glissonean pedicle. This study examined the safety, feasibility, and perioperative outcomes of LASVIIIR via a middle hepatic fissure approach at our institution.

AIM

To investigate the safety, feasibility, and perioperative outcomes of LASVIIIR via a middle hepatic fissure approach at our institution.

METHODS

From November 2017 to December 2022, all patients with a liver tumor who underwent LASVIIIR were enrolled. The perioperative outcomes and postoperative complications were evaluated.

RESULTS

Thirty-four patients underwent LASVIIIR via a middle hepatic fissure approach from the side or cranio side and were included. The mean operation time was 164 ± 54 minutes, and the intra-operative blood loss was 100 mL (range: 20-1000 mL). The mean operative times were, respectively, 152 ± 50 minutes and 222 ± 29 minutes (P = 0.001) for the caudal side and cranial side approaches. In addition, the median blood loss volumes were 100 mL (range: 20-300 mL) and 250 mL (range: 20-1000 mL), respectively, for the caudal and cranial sides (P = 0.064). Three patients treated using the cranial side approach experienced bile leakage, while 1 patient treated using the caudal side approach had subphrenic collection and underwent percutaneous drainage to successfully recover. There were no differences regarding postoperative hospital stays for the caudal and cranial side approaches [9 (7-26) days vs 8 (8-19) days] (P = 0.226).

CONCLUSION

LASVIIIR resection remains a challenging operation, but the middle hepatic fissure approach is a reasonable and easy-to-implement technique.

Keywords: Laparoscopic liver resection; Anatomical liver resection; Middle hepatic fissure approach; Segment VIII resection; Caudal side; Cranial side

Core Tip: Laparoscopic anatomical SVIII resection (LASVIIIR) remains rarely reported due to poor accessibility, difficult exposure, and the deep-lying Glissonean pedicle. In this study, thirty-four patients underwent LASVIIIR via a middle hepatic fissure approach from the side or cranio side and were included. We found that there were no differences regarding postoperative hospital stays for the caudal and cranial side approaches. LASVIIIR remains a challenging operation, but a middle hepatic fissure approach is a reasonable and easy-to-implement technique.