Gon Hidetoshi, Fujisawa Akihiro, Komatsu Shohei, Tanaka Motofumi, Fukushima Kenji, Urade Takeshi, Yoshida Toshihiko, Arai Keisuke, Ishida Jun, Nanno Yoshihide, Tsugawa Daisuke, Yanagimoto Hiroaki, Toyama Hirochika, Kido Masahiro, Fukumoto Takumi
Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7 - 5- 2 Kusunoki-Cho, Chuo-Ku, Kobe, Hyogo, 650 - 0017, Japan.
Department of Surgery, Hyogo Cancer Center, Akashi, Hyogo, Japan.
Surg Today. 2025 Apr 9. doi: 10.1007/s00595-025-03037-7.
We aimed to investigate the differences in surgical difficulty between laparoscopic partial liver resections of segments 7 and 8.
We analyzed 173 patients who underwent partial liver resections of segments 7 or 8 between 2010 and 2022 at two institutions. We investigated differences in the surgical outcomes of each procedure using propensity score matching. We compared these outcomes with those of open partial liver resections for segments 7 and 8 to determine whether the differences were unique to the laparoscopic approach.
Thirty and 54 patients underwent laparoscopic partial liver resections of segments 7 and 8. In the matched cohort (22 in each group), the operation time was significantly longer (377 vs. 278 min, P = 0.020) and the proportion of postoperative complications significantly higher in segment 7 (27% vs. 0%, P = 0.008). Forty-one and 48 patients underwent open partial liver resections of segments 7 and 8, respectively. There were no significant differences in the surgical outcomes between the segments in the matched cohort (20 in each group).
Laparoscopic partial liver resections of segment 7 may be more challenging than that of segment 8. This difference in difficulty was not observed in open partial liver resections.
我们旨在研究腹腔镜下肝段7和肝段8部分肝切除术的手术难度差异。
我们分析了2010年至2022年期间在两家机构接受肝段7或肝段8部分肝切除术的173例患者。我们使用倾向评分匹配法研究了每种手术的手术结果差异。我们将这些结果与肝段7和肝段8的开放性部分肝切除术的结果进行比较，以确定这些差异是否是腹腔镜手术方法所特有的。
30例和54例患者分别接受了腹腔镜下肝段7和肝段8部分肝切除术。在匹配队列（每组22例）中，肝段7的手术时间明显更长（377分钟对278分钟，P = 0.020），术后并发症发生率明显更高（27%对0%，P = 0.008）。41例和48例患者分别接受了肝段7和肝段8的开放性部分肝切除术。在匹配队列（每组20例）中，各肝段之间的手术结果无显著差异。
腹腔镜下肝段7部分肝切除术可能比肝段8更具挑战性。在开放性部分肝切除术中未观察到这种难度差异。
