Left-lateral decubitus jackknife position for laparoscopic resection of right posterior liver tumors: A safe and effective approach.

PURPOSE

To compare outcomes of LLR in VI/VII of the liver in Left-lateral Decubitus Jackknife Position (LDJP) and traditional Supine Position (SP). We used propensity score matching (PSM) to analyze clinical outcomes.

PATIENTS & METHODS: This study retrospectively analyzed patients undergoing LLR for liver tumors in segments VI and/or VII at Shandong Provincial Hospital from 2018 to 2023. A total of 218 cases were included (LDJP, n = 94; SP, n = 124). Matched 1:1 PSM groups were created and clinical indicators compared between groups.

RESULTS

218 LLR patients, 94 LDJP and 124 supine. After 1:1 PSM, each group had 62 patients. No significant differences in clinical or laboratory parameters. All surgeries were successful, 1 LDJP conversion to open resection and 4 SP conversions (P = 0.375). LDJP average surgery duration: 220.6 ± 29.9 min, supine position: 262.6 ± 35.6 min (P < 0.001). LDJP perioperative blood loss: 169.0 ± 74.4 mL, supine position: 231.6 ± 84.6 mL (P < 0.001). Four LDJP patients required intraoperative blood transfusion compared to 16 supine position patients (P = 0.012). All cases had negative margins postoperatively. No significant differences in postoperative complications (8 LDJP vs 9 supine, P = 0.675) or length of hospital stay (25 LDJP vs 26 supine, ≥ 7 days) (P = 1.000).

CONCLUSION

Laparoscopic partial hepatectomy in LDJP for hepatic VI/VII tumor safe and feasible. Reduces operative time, blood loss, transfusion requirement, improving outcomes.