Biobank of Nanjing Drum Tower Hospital, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, People's Republic of China.
Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, People's Republic of China.
BMC Gastroenterol. 2019 Nov 21;19(1):194. doi: 10.1186/s12876-019-1107-9.
Although isolating Glissonean pedicles and hepatic veins are critical procedures during anatomical hepatectomy, there is no standardized approach. We propose the novel Laennec's approach for laparoscopic anatomic hepatectomy (LAH) based on Laennec's capsule, which serves as the anatomic landmark for LAH. The aim of this study was to elucidate that the natural gap between Laennec's capsule and the adjacent tissues contributes to standardization of the surgical technique for LAH.
Eighty-four cases were enrolled in this observable clinical trial. They underwent LAH for liver diseases. Laennec's approach was proposed for LAH based on Laennec's capsule. The liver tissues close to Glissonean pedicle, hepatic veins, naked area, and inferior vena cava were collected for hematoxylin and eosin, resorcinol-fuchsin staining, and immunohistochemistry.
The staining revealed capsule packaging of the whole liver independent of the adjacent tissues and intrahepatic vessels. A natural gap was found between Laennec's capsule and the adjacent tissues at different sites. Laennec's capsule served as the landmark for isolating Glissonean pedicle and hepatic veins, mobilizing the liver, and performing Hanging maneuver. Eighty-four cases underwent LAH for liver diseases using this strategy. The operation time was 277.23 min. The mean of hospital days was 9.8.
Laennec's approach based on Laennec's capsule contributes to standardization of the surgical technique for LAH, and brings innovations that facilitates safe and effective liver resection under laparoscopy.
虽然在解剖性肝切除术中隔离 Glissonean 蒂和肝静脉是关键步骤，但目前尚无标准化方法。我们基于 Laennec 囊提出了新的腹腔镜解剖性肝切除术（LAH）的 Laennec 入路，Laennec 囊作为 LAH 的解剖标志。本研究旨在阐明 Laennec 囊与相邻组织之间的天然间隙有助于 LAH 手术技术的标准化。
本观察性临床试验纳入了 84 例肝脏疾病患者。他们接受 LAH 治疗。根据 Laennec 囊提出了 LAH 的 Laennec 入路。收集靠近 Glissonean 蒂、肝静脉、裸区和下腔静脉的肝组织进行苏木精和伊红、间苯二酚-品红染色和免疫组织化学染色。
染色显示整个肝脏的包膜独立于相邻组织和肝内血管。在不同部位发现 Laennec 囊与相邻组织之间存在天然间隙。Laennec 囊可作为隔离 Glissonean 蒂和肝静脉、游离肝脏和进行 Hanging 操作的标志。84 例肝脏疾病患者采用该策略接受 LAH 治疗。手术时间为 277.23 分钟。平均住院天数为 9.8 天。
基于 Laennec 囊的 Laennec 入路有助于 LAH 手术技术的标准化，为腹腔镜下安全有效肝切除带来创新。
