Xu Jie, Wang Jia-Guo, Lei Kai, Liu Zuo-Jin
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Surg. 2023 May 17;10:1153531. doi: 10.3389/fsurg.2023.1153531. eCollection 2023.
This study aims to summarize our single-center initial experience in laparoscopic pancreatic operation (LPO) combined with hepatic arterial resection and reconstruction, as well as to demonstrate the feasibility, safety, and key surgical procedure for LPO.
We retrospectively analyzed 7 patients who had undergone LPO combined with hepatic arterial resection and reconstruction in our center from January 2021 to December 2022. The clinical data of these 7 patients were collected and analyzed.
In our case series, two patients underwent passive arterial resection and reconstruction due to iatrogenic arterial injury, and five patients underwent forward arterial resection and reconstruction due to arterial invasion. The arterial anastomosis was successful in 5 cases, including 2 cases of end-to-end and 3 cases of arterial transposition, and the vascular reconstruction time was 38.28 ± 15.32 min. There were two conversions to laparotomy. The postoperative recovery of all patients was uneventful, with one liver abscess (Segment 4) and no Clavien III-IV complications. We also share valuable technical feedback and experience gained from the initial practice.
Based on the surgeon's proficiency in open arterial resection and reconstruction and laparoscopic technique. This study demonstrated the feasibility of total laparoscopic hepatic arterial resection and reconstruction in properly selected cases of arterial involvement or iatrogenic arterial injury. Our initial experience provides valuable information for laparoscopic pancreas surgery with arterial resection and reconstruction.
本研究旨在总结我们单中心在腹腔镜胰腺手术（LPO）联合肝动脉切除与重建方面的初步经验，并展示LPO的可行性、安全性及关键手术步骤。
我们回顾性分析了2021年1月至2022年12月在本中心接受LPO联合肝动脉切除与重建的7例患者。收集并分析了这7例患者的临床资料。
在我们的病例系列中，2例因医源性动脉损伤接受了被动动脉切除与重建，5例因动脉侵犯接受了主动动脉切除与重建。动脉吻合成功5例，包括2例端端吻合和3例动脉转位，血管重建时间为38.28±15.32分钟。有2例中转开腹。所有患者术后恢复顺利，出现1例肝脓肿（第4段），无Clavien III-IV级并发症。我们还分享了从最初实践中获得的宝贵技术反馈和经验。
基于外科医生在开放动脉切除与重建及腹腔镜技术方面的熟练程度。本研究证明了在适当选择的动脉受累或医源性动脉损伤病例中，全腹腔镜肝动脉切除与重建的可行性。我们的初步经验为腹腔镜胰腺手术联合动脉切除与重建提供了有价值的信息。
