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微创左半肝切除术:选择合适的手术策略。

Minimally Invasive Left Hepatectomy: Choosing the Suitable Surgical Strategy.

机构信息

Hepato-Biliary and Pancreatic Surgery Unit, Department of Surgery, Hospital Parc Salut Mar, Universitat Pompeu Fabra, Barcelona, Spain.

General Surgery, Minimally Invasive Surgery, Clínica Corachan, Barcelona, Spain.

出版信息

Ann Surg Oncol. 2024 Nov;31(12):7882-7888. doi: 10.1245/s10434-024-15846-0. Epub 2024 Jul 30.

DOI:10.1245/s10434-024-15846-0
PMID:39080131
Abstract

BACKGROUND

Numerous surgical techniques are currently available for minimally invasive left hepatic resection, each offering its own advantages and disadvantages.

PATIENTS AND METHODS

This multimedia manuscript delves into the primary approaches for minimally invasive left hepatectomy, with a focus on particular topics such as left hepatic vein approach, transection and middle hepatic vein exposure, and Glissonean approach. We examine key factors that surgeons should consider when choosing among these methods and provide practical recommendations.

RESULTS

To enhance understanding, our article includes video footage from multiple centres, showcasing expertly executed surgeries for each approach along with their main considerations.

CONCLUSIONS

This multimedia resource will serve as a valuable guide for surgeons, aiding in the selection of the most suitable strategy for minimally invasive left hepatectomies, tailored to the specific needs of the patient and the characteristics of the lesion.

摘要

背景

目前有许多微创左肝切除术的手术技术,每种技术都有其自身的优缺点。

患者和方法

本多媒体手稿深入探讨了微创左肝切除术的主要方法,重点介绍了左肝静脉入路、肝中静脉显露和Glisson 入路等特定主题。我们研究了外科医生在选择这些方法时应考虑的关键因素,并提供了实用建议。

结果

为了增强理解,我们的文章包括来自多个中心的视频片段,展示了每种方法的专家级手术操作及其主要注意事项。

结论

本多媒体资源将成为外科医生的宝贵指南,有助于选择最适合微创左肝切除术的策略,根据患者的具体需求和病变特点进行定制。

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1
Minimally Invasive Left Hepatectomy: Choosing the Suitable Surgical Strategy.微创左半肝切除术:选择合适的手术策略。
Ann Surg Oncol. 2024 Nov;31(12):7882-7888. doi: 10.1245/s10434-024-15846-0. Epub 2024 Jul 30.
2
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J Robot Surg. 2019 Apr;13(2):193-199. doi: 10.1007/s11701-018-0881-7. Epub 2018 Oct 1.
3
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J Hepatobiliary Pancreat Sci. 2012 Jan;19(1):25-9. doi: 10.1007/s00534-011-0445-y.
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Technique of robotic left hepatectomy : how we approach it.机器人辅助左半肝切除术技术:我们的手术方法
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本文引用的文献

1
Indocyanine Green Fluorescence Navigation in Liver Surgery: A Systematic Review on Dose and Timing of Administration.吲哚菁绿荧光导航在肝外科手术中的应用:给药剂量和时间的系统评价。
Ann Surg. 2022 Jun 1;275(6):1025-1034. doi: 10.1097/SLA.0000000000005406. Epub 2022 Feb 2.
2
Laparoscopic glissonean pedicle approach: step by step video description of the technique from different centres (with video).腹腔镜下肝门蒂入路:来自不同中心的该技术分步视频描述(附视频)
Updates Surg. 2022 Jun;74(3):1149-1152. doi: 10.1007/s13304-021-01219-9. Epub 2022 Jan 13.
3
A novel modified hanging maneuver in laparoscopic left hemihepatectomy.
腹腔镜左半肝切除术中一种新型改良悬吊技术。
Int J Surg Case Rep. 2020;76:251-253. doi: 10.1016/j.ijscr.2020.10.002. Epub 2020 Oct 8.
4
Portal vein variants associated with right hepatectomy: An analysis of abdominal CT angiography with 3D reconstruction.与右肝切除术相关的门静脉变异:三维重建腹部CT血管造影分析
Clin Anat. 2019 Apr;32(3):328-336. doi: 10.1002/ca.23315. Epub 2019 Jan 7.
5
Laparoscopy-specific ventral approach in laparoscopic hemihepatectomy.腹腔镜半肝切除术中特定的腹腔镜经腹入路
J Surg Oncol. 2017 Aug;116(2):159-163. doi: 10.1002/jso.24636. Epub 2017 Apr 14.
6
Systematic extrahepatic Glissonean pedicle isolation for anatomical liver resection based on Laennec's capsule: proposal of a novel comprehensive surgical anatomy of the liver.基于赖内克囊的系统性肝外肝门蒂分离用于解剖性肝切除术:一种新型肝脏综合手术解剖学的提议
J Hepatobiliary Pancreat Sci. 2017 Jan;24(1):17-23. doi: 10.1002/jhbp.410.
7
A Modified Liver Hanging Maneuver in Pure Laparoscopic Left Hemihepatectomy with Preservation of the Middle Hepatic Vein: Video and Technique.保留肝中静脉的纯腹腔镜左半肝切除术中改良肝脏悬吊技术:视频与技巧
J Gastrointest Surg. 2017 Jul;21(7):1181-1185. doi: 10.1007/s11605-017-3369-2. Epub 2017 Feb 2.
8
Lateral approach liver hanging maneuver in laparoscopic anatomical liver resections.腹腔镜解剖性肝切除术中的外侧入路肝脏悬吊 maneuver(此处“maneuver”可结合上下文灵活翻译为“操作”“手法”等)
Surg Endosc. 2016 Aug;30(8):3611-7. doi: 10.1007/s00464-015-4663-2. Epub 2015 Nov 5.
9
Selective Control of the Left Hepatic Vein During Laparoscopic Liver Resection: Arentius' Ligament Approach.腹腔镜肝切除术中左肝静脉的选择性控制:阿伦提乌斯韧带入路
J Am Coll Surg. 2015 Oct;221(4):e75-9. doi: 10.1016/j.jamcollsurg.2015.07.009. Epub 2015 Jul 20.
10
Portal vein variations in 1000 patients: surgical and radiological importance.1000例患者的门静脉变异:手术及影像学意义
Br J Radiol. 2015;88(1055):20150326. doi: 10.1259/bjr.20150326. Epub 2015 Aug 18.