Application of selective hemihepatic blood flow occlusion in laparoscopic hepatectomy

doi:10.3321/j.issn:1005-2208.2009.12.022

Abstract：Objective To discuss the technical outline,the effectivity and the feasibility of selective hemihepatic blood flow occlusion in laparoscopic hepatectomy.Methods Thirty-seven patients performed by laparoscopic hepatectomy with selective hemihepatic blood flow occlusion between March 1,2007 and September 30,2008 in the Institute of Hepatobiliary Surgery of PLA,Southwest Hospital of the Third Military Medical University were investigated retrospectively.Results Eleven patients were treated with fight hemihepatic blood flow occlusion and 6 of whom underwent fight hepatic vein occlusion.Twenty-six patients were treated with left hemihepatic blood flow occusion and 18 of whom underwent middle and left hepatic vein occlusion.Twenty patients were performed left hemihepatectomv.One patient performed extended left hemihepatectomy.Five patients performed left lateral segmentectomv.Four patients performed right hcmihepatectomy.Two patients performed right posterior lobe resection.Three patients performed segment Ⅵ resection and 2 patients performed h,cal resection(part of Ⅴ and Ⅵ).Among those procedure,12 patients combined with biliary track exploration and T-tube drainage and 1 patient combined with appendectomy.The mean operation time was 190 minutes(110-490 minutes).The mean bleeding volume was 340 minutes(100-1200m L).A conversion to open surgery was required in 1 patient because of injury of right hepatic vein.Right hydrothorax and encapsulated effusion on liver cross section developed in two each.Conclusion Selective hemihepatic blood flow occlusion in laparoscopic hepatectomy is an effective and feasible technique.It is applied to laparoscopic hemihepatectomy and laparoscopic hepatectomy for cirrhotic patients.