A systematic surgical procedure: The '7+3' approach to laparoscopic right partial hepatectomy [deep segment (S) VI, S VII or S VIII] in 52 patients with liver tumors

摘要

Laparoscopic right partial hepatectomy (LRPH), located in the deep segment (S) VI, S VII or S VIII, is a complicated procedure, due to its poor operative field and high risk of bleeding. The present study aimed to summarize our experience of LRPH and to share our systematic surgical procedure, the '7+3' approach. This approach includes seven key points and three main instruments. A total of 81 cases were included, which were divided into 2 groups [LRPH, n=52; open hepatectomy (OH), n=29]. The demographic profile, intraoperative parameters and postoperative parameters were obtained and analyzed. Blood loss (245.38 +/- 268.37 ml) in the LRPH group was not significantly more than in the OH group (230.93 +/- 257.62 ml; P=0.936). The durations of surgery, liver parenchyma transection and portal triad clamping were also not significantly more than those in the OH group (145.52 +/- 48.29 vs. 129.83 +/- 35.04 min; P=0.149 for surgery; 28.52 +/- 10.16 vs. 23.97 +/- 10.44 min; P=0.059 for liver parenchyma transection; 20.62 +/- 9.61 vs. 17.31 +/- 10.12 min; P=0.149 for portal triad clamping). However, the number of postoperative hospital days in the LRPH group was smaller (10.67 in LRPH vs. 12.07 in OH; P=0.025). The present study demonstrated the satisfactory surgical outcomes and economic benefits of the systematic '7+3' surgical technique for LRPH. Further studies in larger cohorts and other centers are required to confirm its feasibility and superiority.