Applications Of Laparoscopic Ultrasound In Laparoscopic Anatomical Hepatectomy

Objective: To discuss the application value of laparoscopic ultrasound(LUS) in laparoscopic left hemihepatectomy(LLH).Methods: Choosed 66 patients who underwent laparoscopic left hemihepatectomy from Mar 2011 to Mar 2014 in the department of minimally invasive hepato-biliary surgery in Lihuili hospital. There were 48 cases of hepatolithiasis and 18 cases of primary hepatic carcinoma. Among them 36 patients examined by LUS were divided into ultrasound group(group A), the other 30 patients without LUS were divided into control group(group B). The operative time, the intra-operative blood loss, the damage rate of the middle hepatic vein, the incidence of conversion to laparotomy, the postoperative complications, the distance of tumor incisal margin and the postoperative hospital stay were compared. Datum were analysed by standard statistical software SPSS17.0. Measurement data using mean±standard deviation, enumeration data using chi-square test.Results: All the patients were in accord with the inclusive criteria of the study. All the 36 patients in group A were completed with laparoscopic left hemihepatectomy successfully, 4 patients in group B were converted to laparotomy. The differences of the operative time, the postoperative complications and the postoperative hospital stay between the two groups had no statistical significance(P > 0.05); The differences of the intra-operative blood loss, the damage rate of the middle hepatic vein, the incidence of conversion to laparotomy and the incisal margin distance of malignant tumor in A group were all statistically significant with B group’s(P < 0.05). There was no case of intraoperative and in-hospital death. All of them were followed up for 6-18 months postoperatively, the average was 12 months.Conclusions: LUS in laparoscopic left hemihepatectomy will not prolong the operative time significantly. LUS can not decrease the postoperative complications and shorten the hospital stay. But LUS can effectively reduce the intraoperative blood loss, reduce the injury of middle hepatic vein to avoid converting to laparotomy. LUS can provide enough distance for the incisal margin to ensure the radical excision of the tumor. From the above, LUS could provide “guidance” for laparoscopic left hemihepatectomy. It increased the safty and worth to be popularized in LLH.