Department of General Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China.
Sci Rep. 2019 Dec 11;9(1):18809. doi: 10.1038/s41598-019-52694-5.
Laparoscopic hepatectomy (LH) has been accepted widely owing to its advantages as a minimally invasive surgery; however, laparoscopic right hemihepatectomy (LRH) has rarely been reported. We aimed to compare the benefits and drawbacks of LRH and open approaches. Between January 2014 and October 2017, 85 patients with tumor and hepatolithiasis who underwent LRH (n = 30) and open right hemihepatectomy (ORH) (n = 55) were enrolled in this study. For tumors, LRH showed significantly better results with respect to blood loss (P = 0.024) and duration of hospital stay (P = 0.008) than ORH, while hospital expenses (P = 0.031) and bile leakage rate (P = 0.012) were higher with LRH. However, the operative time and rate of other complications were not significantly different between the two groups. However, for hepatolithiasis, there was less blood loss (P = 0.015) and longer operative time (P = 0.036) with LRH than with ORH. There were no significant difference between LRH and ORH in terms of hospital stay, hospital expenses, and complication rate (P > 0.05). Moreover, the postoperative white blood cell count, alanine aminotransferase level, aspartate aminotransferase level, and total bilirubin were not significantly different in both types of patients (P > 0.05). Our results suggest the safety and feasibility of laparoscopy technology for right hemihepatectomy in both tumor and hepatolithiasis patients.
腹腔镜肝切除术 (LH) 因其作为微创手术的优势而被广泛接受；然而，腹腔镜右半肝切除术 (LRH) 很少有报道。我们旨在比较 LRH 和开放方法的优缺点。在 2014 年 1 月至 2017 年 10 月期间，85 名患有肿瘤和肝胆管结石的患者接受了 LRH（n=30）和开放右半肝切除术（ORH）（n=55）。对于肿瘤，LRH 在出血量（P=0.024）和住院时间（P=0.008）方面明显优于 ORH，而住院费用（P=0.031）和胆漏率（P=0.012）较高与 LRH。然而，两组之间的手术时间和其他并发症发生率没有显著差异。然而，对于肝胆管结石，LRH 的出血量较少（P=0.015），手术时间较长（P=0.036）。与 ORH 相比，LRH 在住院时间、住院费用和并发症发生率方面没有显著差异（P>0.05）。此外，两种类型的患者术后白细胞计数、丙氨酸转氨酶水平、天冬氨酸转氨酶水平和总胆红素均无显著差异（P>0.05）。我们的结果表明，腹腔镜技术在肿瘤和肝胆管结石患者中进行右半肝切除术是安全可行的。
