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Effective surgical techniques for laparoscopic hepatic resection Yoshihiko NAKAMOTO 1 , Ritsuko MAEHARA 1 , Ryuichi MIKAMI 1 , Hiroyuki KAYATA 1 , Hirokuni IKEDA 1 , Mitsuo YAMAMOTO 1 1Department of Surgery, Kobe City Medical Center West Hospital Keyword: 腹腔鏡下肝切除術 , 肝切除術 , 腹腔鏡下手術 pp.827-832
Published Date 2012/12/15
DOI https://doi.org/10.11477/mf.4426100875
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 To evaluate what techniques and devices were safe and effective, we reviewed clinical profiles of 37 patients who underwent laparoscopic hepatic resection (LHR) between December 2006 and September 2011. Twenty-five patients had hepatocellular carcinomas with liver cirrhosis. Out of them, 21 patients underwent partial resections of the liver, and 4 patients underwent lateral segmentectomy. Hand-assisted laparoscopic surgery was performed in 7 patients. The mean operation time was 199 minutes and the mean blood loss was 147 ml. On the other hand, 12 patients without liver cirrhosis had metastatic liver tumors or gallbladder carcinoma. We performed a partial resection of the hepatic segment in 9, lateral segmentectomy in 2, and right hepatectomy in 1. The mean operation time was 176 minutes and the mean blood loss was 49 ml. According to our LHR experiences, crushing the liver parenchyma with BiClamp® forceps followed by dissecting with a vessel sealing system was most effective for cirrhotic hard liver resection. To dissect a normal liver, the Cavitron ultrasonic surgical aspirator(CUSA®) was applicable prior to the vessel sealing system. An endolinear stapler was also applicable for quick dissection of the liver. It was important to adopt appropriate laparoscopic techniques and devices according to the location of tumors and the degree of liver cirrhosis.


Copyright © 2012, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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