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Decai Yu
Nanjing Drum Tower Hospital Department of Liver and Gall Bladder Surgery
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3006-2531
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Background: Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. We previously reported that Glissonian approach combined with major hepatic vein first was effective for LAH. Because dorsal approach could effectively expose the major hepatic vein, we merged it with Glissonian approach in LAH for the right lobe.
Methods: Twenty patients who underwent LAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). First, the paracaval portion of caudate lobe along the IVC was transected through dorsal approch after the corresponding hepatic pedicles were isolated through Glissonian approach. Next, the liver parenchyma was transected by dorsal approach until the corresponding major hepatic vein was exposed from its trunk to the root. Then, the liver parenchyma was transected by a ventral approach. Finally, the root of the major hepatic vein was transected.
Results: The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05).
Conclusions: Dorsal approach combined with Glissonian approach for right lobe in LAH is feasible and effective, although it is essential to include more cases for further study.
Keywords
Dorsal approach, Hepatectomy, Laparoscopy, Surgical procedure
Figure 1
Figure 2
Figure 3
Figure 4
This is a list of supplementary files associated with this preprint. Click to download.
- Supplementalvideo1LRH.mp4
Supplemental Video 1: Dorsal approach with Glissonian approach in laparoscopic right hemihepatectomy (LRH)
- Supplementalvideo2LRPH.mp4
Supplemental Video 2: Dorsal approach with Glissonian approach in laparoscopic right posterior hepatectomy (LRPH)
- Supplementalvideo3LS7.mp4
Supplemental Video 3: Dorsal approach with Glissonian approach in laparoscopic hepatectomy for segment 7 (LS7)
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CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
Version 3
Posted 04 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 03 Feb, 2021
Review #1 received
Received 26 Jan, 2021
Reviewer #1 agreed
On 14 Jan, 2021
Reviewers invited
Invitations sent on 11 Sep, 2020
Editor assigned
On 04 Sep, 2020
Submission checks complete
On 03 Sep, 2020
Editor invited
On 03 Sep, 2020
No comments provided
Editorial decision: Major revision
On 07 Aug, 2020
Editor assigned
On 05 Aug, 2020
Submission checks complete
On 04 Aug, 2020
Editor invited
On 04 Aug, 2020
Community comments: 9
Editorial decision: Major revision
On 09 Jul, 2020
Review #4 received
Received 30 Jun, 2020
Reviewer #4 agreed
On 24 Jun, 2020
Review #3 received
Received 12 Jun, 2020
Reviewer #3 agreed
On 25 May, 2020
Review #2 received
Received 14 May, 2020
Review #1 received
Received 17 Mar, 2020
Reviewer #2 agreed
On 27 Feb, 2020
Reviewers invited
Invitations sent on 25 Feb, 2020
Reviewer #1 agreed
On 25 Feb, 2020
Submission checks complete
On 13 Feb, 2020
Editor invited
On 13 Feb, 2020
Editor assigned
On 10 Feb, 2020
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Subject Areas
Gastroenterology & Hepatology
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Gastroenterology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Technical advance
Decai Yu
Nanjing Drum Tower Hospital Department of Liver and Gall Bladder Surgery
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3006-2531
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
Version 3
Posted 04 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 03 Feb, 2021
Review #1 received
Received 26 Jan, 2021
Reviewer #1 agreed
On 14 Jan, 2021
Reviewers invited
Invitations sent on 11 Sep, 2020
Editor assigned
On 04 Sep, 2020
Submission checks complete
On 03 Sep, 2020
Editor invited
On 03 Sep, 2020
No comments provided
Editorial decision: Major revision
On 07 Aug, 2020
Editor assigned
On 05 Aug, 2020
Submission checks complete
On 04 Aug, 2020
Editor invited
On 04 Aug, 2020
Community comments: 9
Editorial decision: Major revision
On 09 Jul, 2020
Review #4 received
Received 30 Jun, 2020
Reviewer #4 agreed
On 24 Jun, 2020
Review #3 received
Received 12 Jun, 2020
Reviewer #3 agreed
On 25 May, 2020
Review #2 received
Received 14 May, 2020
Review #1 received
Received 17 Mar, 2020
Reviewer #2 agreed
On 27 Feb, 2020
Reviewers invited
Invitations sent on 25 Feb, 2020
Reviewer #1 agreed
On 25 Feb, 2020
Submission checks complete
On 13 Feb, 2020
Editor invited
On 13 Feb, 2020
Editor assigned
On 10 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Gastroenterology & Hepatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Gastroenterology.
Background: Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. We previously reported that Glissonian approach combined with major hepatic vein first was effective for LAH. Because dorsal approach could effectively expose the major hepatic vein, we merged it with Glissonian approach in LAH for the right lobe.
Methods: Twenty patients who underwent LAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). First, the paracaval portion of caudate lobe along the IVC was transected through dorsal approch after the corresponding hepatic pedicles were isolated through Glissonian approach. Next, the liver parenchyma was transected by dorsal approach until the corresponding major hepatic vein was exposed from its trunk to the root. Then, the liver parenchyma was transected by a ventral approach. Finally, the root of the major hepatic vein was transected.
Results: The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05).
Conclusions: Dorsal approach combined with Glissonian approach for right lobe in LAH is feasible and effective, although it is essential to include more cases for further study.
Figure 1
Figure 2
Figure 3
Figure 4
This is a list of supplementary files associated with this preprint. Click to download.
- Supplementalvideo1LRH.mp4
Supplemental Video 1: Dorsal approach with Glissonian approach in laparoscopic right hemihepatectomy (LRH)
- Supplementalvideo2LRPH.mp4
Supplemental Video 2: Dorsal approach with Glissonian approach in laparoscopic right posterior hepatectomy (LRPH)
- Supplementalvideo3LS7.mp4
Supplemental Video 3: Dorsal approach with Glissonian approach in laparoscopic hepatectomy for segment 7 (LS7)
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