Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
Clinica Veterinaria Nervianese, Nerviano, Milan, Italy.
Vet Surg. 2021 Jul;50 Suppl 1:O89-O98. doi: 10.1111/vsu.13566. Epub 2021 Feb 11.
To determine the feasibility of laparoscopic liver lobectomy (LLL) in dogs by using canine cadavers and to describe the clinical application in dogs with liver disease.
Ex vivo experiment and descriptive case series.
Twelve canine cadavers and six client-owned dogs.
Cadavers underwent LLL with an endoscopic stapler. The percentage of liver lobe resected was determined by volume. The distance from the staple line to hilus was measured. Medical records of dogs undergoing LLL were reviewed.
In cadavers ≤15 kg, left lateral lobectomy completeness was 87.3% (84.6%-96.6%), and remaining median (interquartile range) hilar length was 1 cm (0.25-1.75). Left medial lobectomy completeness was 72.5% (66.7%-80%), and remaining hilar length was 1.6 cm (0.47-1.75). Central division resection completeness was 68.3% (60%-92.9%), and remaining hilar length was 2.7 cm (0.8-5). Laparoscopic liver lobectomy was not feasible for right division lobes and in cadavers >15 kg. Five dogs with peripheral quadrate or left lateral lobe masses underwent stapled, partial laparoscopic lobectomy (30%-90%). One dog underwent stapled, left lateral lobectomy (90%) after open procedure conversion. Histopathological diagnoses included hepatocellular carcinoma (3), nodular hyperplasia (1), biliary cyst adenoma (1), and fibrosis (1).
Laparoscopic liver lobectomy of the left and central divisions is feasible in cadavers ≤15 kg with an endoscopic stapler. Partial LLL of the left and central divisions is feasible in select dogs with liver disease.
Laparoscopic liver lobectomy may be a viable alternative to laparotomy in small-to-medium size dogs with peripheral liver masses of the left and central divisions.
通过使用犬尸体来确定腹腔镜肝叶切除术（LLL）在犬中的可行性，并描述其在肝病犬中的临床应用。
离体实验和描述性病例系列。
十二只犬尸体和六只患犬。
使用内镜吻合器对犬尸体进行 LLL。通过体积确定切除的肝叶比例。测量吻合线到肝门的距离。回顾接受 LLL 的犬的病历。
在体重≤15kg 的犬尸体中，左外侧叶切除术的完全性为 87.3%（84.6%-96.6%），剩余的中位（四分位间距）肝门长度为 1cm（0.25-1.75cm）。左内侧叶切除术的完全性为 72.5%（66.7%-80%），剩余的肝门长度为 1.6cm（0.47-1.75cm）。中央叶切除术的完全性为 68.3%（60%-92.9%），剩余的肝门长度为 2.7cm（0.8-5cm）。腹腔镜肝叶切除术不适用于右叶和体重>15kg 的犬尸体。五只因外周方叶或左外侧叶肿块接受吻合器部分腹腔镜叶切除术（30%-90%）。一只犬在开放手术转换后接受吻合器左外侧叶切除术（90%）。组织病理学诊断包括肝细胞癌（3）、结节性增生（1）、胆管囊腺瘤（1）和纤维化（1）。
使用内镜吻合器，体重≤15kg 的犬的左叶和中叶可以进行腹腔镜肝叶切除术。选择性肝病犬的左叶和中叶部分 LLL 是可行的。
腹腔镜肝叶切除术可能是左叶和中叶外周肿块的小型至中型犬的一种可行的剖腹手术替代方法。
