The Application Of Laparoscopic Ultrasound In Laparoscopic Hepatectomy

Objective: To investigate the advantages and expand the applicationof laparoscopic ultrasound(LUS)in laparoscopic hepatectomy.Methods: The clinical data of Seventy-seven patients underwent laparoscopic hepatectomy at the department of hepatobiliary surgery of the Affiliated Hospital of North Sichuan Medical College from Jan 2015 to Jan 2017 were retrospectively analyzed.Thity-three cases performed LUS were assigned to the ultrasound group(sixteen cases with hepatolithiasis and seventeen cases of primary hepatic carcinoma),Forty-four cases not performed LUS were assigned to the general group(Twenty-one cases of hepatolithiasis and Twenty-three cases of primary hepatic carcinoma).the baseline characteristics,the rate of“additional lesions” detection,middle hepatic vein damage,conversion to laparotomy,blood transfusion,hepatic portal block,and incidence of the postoperative complications,the operative time,the operative blood loss,the hospital stay,and the lesions residue or recurrence was respectivelyanalyzed.The liver function includingALT,AST,ALB,TBIL at day1,day3,and day5 after operation were also analysed.Results: The surgery of all the patients in the ultrasound group and the general group were successfully completed.No perioperative death occurred.There was no significant difference in the age,sex,body mass index(BMI),preoperative liver function(ALT,AST,ALB,TBIL),prothrombin time(PT),Child-Pugh classification,the rate of disease composition,and the proportion of operation method between the two groups,respectively(P>0.05).Moreover,there was no significant difference in the operation time,the conversion to laparotomy,the incidence of postoperative complications,and the lesions residue and recurrencebetween the two groups(P>0.05).The rate of “additional lesions” detection in the ultrasound group was higher than that in the general group(P<0.05).However,the rate of hepatic vein injury,intraoperative blood transfusion,hepatic portal block,and postoperative complications with Ⅲ~ Ⅲstage in the ultrasound group were lower than that in the general group(P<0.05).Moreover,the operative blood loss andhospital stay in the ultrasoundgroup was less than that in the general group(P<0.05).The cases in theultrasound group exhibited more stable liver function than that in general group at day1,day3,and day5 after operation(P< 0.05).Conclusions: LUS can increase the rate of “additional lesions” detection.More importantly,LUS can reduce the rate of the hepatic vein injury,intraoperative blood transfusion,hepatic portal block,and the postoperative complications with Ⅲ~ Ⅲstage,decrease the operative blood loss,shorten the hospital stayand benefit to recovery.In total,LUS canimprove the safety and precision in laparoscopic liver resection surgery by “precise positioning” and “real-time navigation”.It worth to be widelypopularized in laparoscopy hepatectomy.