Institute of Hepatobiliary Surgery of the Army, Southwest Hospital, Army Medical University, Chongqing, China.
Chinese Research Group for Minimally Invasive Anatomical Liver Resection (The Workshop of Liver Future [WOLF]), Beijing, China.
Ann Surg Oncol. 2024 Dec;31(13):9183-9185. doi: 10.1245/s10434-024-16215-7. Epub 2024 Sep 12.
Laparoscopic anatomic segment 8 resection (LAR-S8) remains a technical challenge due to the special location of S8 and the complex classification of the Glissonean pedicle of S8 (G8). Particularly for situations in which multiple grade 4 hepatic pedicles branch out from the same point at 360° in a dandelion pattern from the right anterior hepatic pedicle, effective methods for accurately locating the target G8 and the intersegmental plane between S8 and the adjacent hepatic segment remain lacking.
This report describes a LAR-S8 guided by the indocyanine green (ICG) negative-staining method using the "taping game for complex G8 Glissonean approach" in a patient with a typical dandelion-patterned G8.
The operative time was 150 min, with a blood loss of 50 mL and no complications. The patient was discharged 5 days postoperatively. Regular follow-up evaluation during 24 months showed no recurrence.
The taping game is an effective method for S8 resection, especially for patients with complex G8 patterns such as the dandelion pattern.
由于 S8 的特殊位置和 S8 的 Glissonean 蒂(G8)的复杂分类,腹腔镜解剖性 S8 切除术(LAR-S8)仍然是一项技术挑战。特别是对于右前肝蒂上 360°呈蒲公英状从同一部位分出多个 4 级肝蒂的情况,有效方法来准确定位目标 G8 和 S8 与相邻肝段之间的节段间平面仍然缺乏。
本报告描述了一名患者使用“复杂 G8 Glissonean 入路的胶带游戏”指导下的 ICG 负染法行 LAR-S8 的情况,该患者的 G8 呈典型的蒲公英状。
手术时间为 150 分钟,出血量 50 毫升,无并发症。患者术后 5 天出院。24 个月的定期随访评估显示无复发。
胶带游戏是 S8 切除的有效方法,特别是对于 G8 模式复杂的患者,如蒲公英模式。