Application of the two-surgeon technique in complex laparoscopic hepatectomy

GAO Miao; MENG Fan-zheng; SONG Hua-chuan; ZHANG Shen-yu; WANG Yong-shuai; LIU Lian-xin; WANG Ji-zhou; SONG Rui-peng

doi:10.19538/j.cjps.issn1005-2208.2025.03.17

Abstract：Objective To compare the perioperative efficacy of the two-surgeon technique(TST)and single-surgeon technique(SST)in treating hepatocellular carcinoma(HCC)through difficult laparoscopic hepatectomy.Methods Clinical data of HCC patients undergoing laparoscopic hepatectomy at the First Affiliated Hospital of the University of Science and Technology of China between January 2021 and September 2023 were retrospectively analyzed.Patients were divided into the TST(n=35)and SST(n=39)groups.Key perioperative outcomes,including operative time,intraoperative blood loss,transfusion rate,hilar occlusion time,and postoperative complication rates,were compared between the two groups.Results In high-difficult cases,the operative time was significantly shorter in the TST group compared to the SST group[(199.5±50.4)min vs.(254.4±82.9)min,P=0.001],and intraoperative blood loss was significantly reduced[100.0(100.0,200.0)mL vs.200.0(100.0,400.0)mL,P=0.001].The level of alanine aminotransferase was lower on the third day after the operation[101.80(32.80,834.60)U/L vs.159.10(21.10,1005.00)U/L,P=0.027].However,the hospitalization costs of the TST group were higher than those of the SST group(P=0.025).There were no significant differences in transfusion rate,hilar occlusion time,or postoperative complication rates between the two groups.Conclusion The TST demonstrates comparable safety in complex laparoscopic hepatectomy while offering advantages of shorter operative time and reduced intraoperative blood loss and promote the recovery of liver function.