Objective: To study the clinical effect of segmental resection of the liver using Glissonean pedicle transection for primary liver cancer.
Methods: The clinical data of 55 primary liver cancer patients admitted from January 2006 to October 2008 were analyzed retrospectively. Twenty-five of the patients underwent segmental resection of the liver by Glissonean pedicle transection (group A), and 30 underwent routine hepatectomy (group B). The positivity rate of the resection margin, micrometastasis in the hepatic parenchyma surrounding the lesions and postoperative recurrence rates were investigated.
Results: The positivity rate of the resection margin was 4.0% in group A, significantly lower than that of group B. The number of histological micrometastasis was significantly higher in group A than in group B (16 vs 8). The median distance of histological micrometastasis was 6.8 mm (2.7-25.6 mm) in group A and 4.2 mm (2.4-9.0 mm) in group B. The one-year recurrence rate was significantly lower in group A than in group B (16% vs 26.7%).
Conclusion: Glissonean pedicle transection for segmental liver resection is a simpler procedure than routine hepatectomy for primary liver cancer and can reduce the number of histological micrometastasis and recurrence rate.
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Langenbecks Arch Surg
January 2025
Department of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Introduction: The impact of the distance of the tumor from the main hepatic vessels (DTV), such as the Glissonean pedicle or hepatic veins, on oncological outcomes for Hepatocellular carcinoma (HCC) patients is relatively understudied. Therefore, the objective of this study was to explore the correlation between DTV and survival in patients with HCC after curative hepatic resection.
Methods: Consecutive patients who underwent curative-intent liver surgery for HCC between April 2018 and May 2023 were identified from a prospective database.
Asian J Endosc Surg
January 2025
Department of Gastroenterological Surgery, Miyagi Cancer Center, Natori, Japan.
Constitutional indocyanine green (ICG) excretion defect (CIED) is a rare clinical condition characterized by markedly delayed ICG disappearance with other normal liver function tests. Here, we report a case of CIED in which laparoscopic anatomical liver resection was successfully performed using ICG fluorescence staining. A 64-year-old man with a 4-cm tumor located in the liver segment 5 was referred to our hospital.
View Article and Find Full Text PDFWorld J Gastrointest Surg
December 2024
Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China.
Background: Laparoscopic hepatectomy is a proven safe and technically feasible approach for liver tumor resection, but laparoscopic anatomical SVIII resection (LASVIIIR) remains rarely reported due to poor accessibility, difficult exposure, and the deep-lying Glissonean pedicle. This study examined the safety, feasibility, and perioperative outcomes of LASVIIIR a middle hepatic fissure approach at our institution.
Aim: To investigate the safety, feasibility, and perioperative outcomes of LASVIIIR a middle hepatic fissure approach at our institution.
World J Gastrointest Surg
December 2024
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Background: Laparoscopic anatomical liver resection has become more challenging because some subsegmental Glissonean pedicles are hard to dissect. Here, we introduce how to dissect every (sub) segmental Glissonean pedicle from the first porta hepatis and perform standardized (sub) segmentectomy [from segment 1 (S1) to S8].
Aim: To summarize our methods of laparoscopic anatomical segmental and subsegmental liver resection.
Ann Surg Oncol
December 2024
Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Korea.
Background: Conventional right hepatectomy typically involves resection of the right hemiliver, often including partial removal of the caudate lobe. However, recent advancements, particularly in indocyanine green (ICG) fluorescence imaging, have allowed for more accurate identification of anatomical boundaries between liver segments. In this context, we present a refined technique for real anatomical right hepatectomy that preserves the caudate lobe, offering enhanced surgical precision and several distinct advantages over traditional methods.
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