Comparison of the effect of laparoscopic anatomic hepatectomy by Laennec approach and traditional laparoscopic anatomic hepatectomy by Glisson pedicle

Abstract

Abstract: Objective To compare the efficacy of Laennec approach laparoscopic anatomic hepatectomy with traditional Glisson pedicle anatomic laparoscopic hepatectomy. Methods 97 patients with hepatic tumor, hepatolithiasis and hepatic hemangioma were selected for prospective study. Patinets were divided into 2 groups according to random number table method, and underwent laparoscopic ananatomical hepatectomy via Glisson hepatic pedicle and Laennec approach respectively. The surgical indexes and adverse events were compared between the two groups. Serum indexes(ALT,AST,Alb)were analyzed. Results In the observation group, the operation time was(164.3±31.9)min, the hilar occlusion time was(51.0±6.1)min, the perihepatic free time was(15.5±3.7)min, the liver pedicle separation time was(19.5±4.8)min, the posthepatic separation time was(5.5±1.3)min, and the hepatic parenchyma separation time was(41.0±7.2)min and hospitalization time was(10.3±3.1)d,which were shorter than control group[(196.5±34.8)min,(67.0±5.6)min,(19.0±4.3)min,(24.5±5.4)min,(7.5±2.1)min,(47.0±7.5)min,(13.0±3.4)d]. The intraoperative blood loss(232.4±47.5)mL was lower than that of the control group(284.6±52.3)mL. The overall incidence of adverse events(0%) lower than control group (10%), and the postoperative serum Alb level(38.6±5.1)g/L was higher than the control group (34.2±3.5)g/L. The levels of serum ALT(276.8±13.1)U/L and AST(253.6±15.4)U/L were lower than those of control group after operation[(315.5±14.2)U/L,(297.6±16.5)U/L](P<0.05). Conclusion Compared with traditional laparoscopic hepatectomy via Glisson pedicle dissection, Laennec approach is not only shorter in operation time, but also more beneficial to liver function and postoperative rehabilitation.

Key words: Laennec approach, Laparoscopic anatomic hepatectomy, Glisson hepatic pedicle, Compare

WANG Cai-qing, FANG Jian, XIE Dong-dong, XU Liang-ming, YU De-cai. Comparison of the effect of laparoscopic anatomic hepatectomy by Laennec approach and traditional laparoscopic anatomic hepatectomy by Glisson pedicle[J]. Chinese Hepatolgy, 2025, 30(11): 1568-1571.

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