Guo Yusheng, Huang Wenhao, Luo Biwei, Bi Jiangang, Liu Liping, Bao Shiyun, Zhang Yusen
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology).
Division of Hepatobiliary and Pancreas Surgery, Department of General Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology);
J Vis Exp. 2025 Jun 6(220). doi: 10.3791/67865.
Hepatectomy is the primary treatment for hepatocellular carcinoma (HCC) and is categorized into anatomical hepatectomy and non-anatomical hepatectomy based on the extent of resection. Anatomical hepatectomy utilizes the portal territory (PT) liver segment or subsegment as the basic anatomical unit, systematically resecting the tumor-bearing PT and completely removing the Glisson system that supplies and demarcates this area to enhance oncological efficacy. Non-anatomical hepatectomy follows the principle of radical oncological resection, emphasizing the removal of liver tissue more than 1 cm away from the tumor margin. With the popularization of precision surgery concepts, minimally invasive anatomical hepatectomy based on PTs has been widely applied. However, the minimally invasive resection of segment S8 of the liver is still considered one of the most challenging liver resections. We successfully performed an anatomical resection of portal territory segment S8 of the liver using intraoperative ultrasound, fluorescent laparoscopy, and Lannaec membrane dissection techniques, achieving good short-term clinical outcomes.
肝切除术是肝细胞癌(HCC)的主要治疗方法,根据切除范围可分为解剖性肝切除术和非解剖性肝切除术。解剖性肝切除术以门静脉区域(PT)肝段或亚段作为基本解剖单位,系统切除含肿瘤的PT,并完全去除供应和划分该区域的Glisson系统,以提高肿瘤学疗效。非解剖性肝切除术遵循肿瘤根治性切除原则,强调切除距肿瘤边缘1 cm以上的肝组织。随着精准手术概念的普及,基于PTs的微创解剖性肝切除术已得到广泛应用。然而,肝脏S8段的微创切除仍被认为是最具挑战性的肝脏手术之一。我们使用术中超声、荧光腹腔镜和蓝膜剥离技术成功实施了肝脏门静脉区域S8段的解剖性切除,取得了良好的短期临床效果。