Clinical Comparative Study Of Glissonean Pedicle Transection Hepatectomy And Pringle Block Hepatectomy In The Treatment Of Liver Cancer

Objectives:1.To compare the clinical efficacy and prognosis of Glissonean pedicle transection hepatectomy and Pringle block hepatectomy in the treatment of primary liver cancer.Methods:Retrospective analysis of clinical data of 90 patients with primary liver cancer who underwent partial hepatectomy at the Hepatobiliary Surgery Department of the Second Affiliated Hospital of Kunming Medical University from January 2016 to June 2019.Glissonean pedicle transection hepatectomy(group A n=45)and Pringle’s method were used to block the first hepatic hilum by surgery(group B n=45).Preoperative(gender,age,Child-Pugh grade,tumor diameter,HB,ALB,AST,ALT,TBIL),intraoperative(operative time,intraoperative blood loss,intraoperative blood transfusion),postoperative(ALB,AST,ALT,TBIL on days 1,3,and 7 postoperatively)and the amount of intraperitoneal drainage fluid,postoperative hospital stay,incidence of complications,and tumor-free survival were statistically analyzed and compared the presence of differences between group A and group B to provide the basis for the selection of surgical methods for patients with liver cancer.Results:There was no significant difference in gender,age,tumor diameter,child-pugh grade,HB,ALB,ALT,AST and TBIL between the two groups(P>0.05);the results are comparable.There was no significant difference in the operative time,intraoperative blood loss and intraoperative blood transfusion between the two groups(P>0.05).The amount of intraperitoneal retention 2 days after operation in group A was significantly less than that in group B(P<0.05).The hospital stay of group A was shorter than that of group B(P<0.05).The incidence of postoperative complications in group A was 15.56%,and the incidence of postoperative complications in group B was 35.56%.The incidence of postoperative complications in both groups was statistically significant(P<0.05).The level of ALT,AST,and TBIL in group A was lower than that in group B at 1 day,3 days,and 7 days after operation(P<0.05).There was no statistically significant difference between group A and group B in ALB 1,3 and 7 days after surgery(P>0.05).The 1-year tumor-free survival rate of group A was 84.6%,which was higher than that of group B,which was 70.4%.However,there was no statistically significant difference in the cumulative tumor-free survival rate between the two groups by log-rank test(P>0.05).Conclusions:1.This study found that there was no significant difference between Glissonean pedicle transection hepatectomy and Pringle block hepatectomy in terms of operation time,intraoperative blood loss,intraoperative blood transfusion,and 1-year tumor-free survival rate.However,the former has advantages in the recent clinical efficacy and liver function recovery.2.Glissonean pedicle transection hepatectomy is a surgical method of anatomical hepatectomy.It always treats the "portal tube triple" as a whole,not limited by the length of the block,and have little effect on hemodynamics of residual liver.It is a simple,safe and feasible surgical plan,and it is worthy of clinical application.