Contrastive Study Of Laparoscopic Left Hemihepatectomy With Extrahepatic Glisson Pedicle Transection Based On Laennec’s Capsule Theory And Intrahepatic Glisson Pedicle Anatomical Occlusion

Objective: To investigate the safety,feasibility and application value of laparoscopic left hemihepatectomy with Glisson pedicle transection based on Laennec’s capsule theory.Methods: The clinical data of 44 patients who underwent laparoscopic left hemihepatectomy in the Department of Hepatobiliary Surgery,the Affiliated Hospital of Youjiang Medical University for Nationalities from September 2017 to September 2020 were retrospectively analyzed.According to the different surgical methods,they were divided into two groups: the extrahepatic Glisson pedicle group(n = 21)treated with extrahepatic Glisson pedicle transection based on Laennec’s capsule theory,and the intrahepatic Glisson pedicle group(n = 23)treated with intrahepatic Glisson pedicle anatomical occlusion.Results: There was no difference in general information,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),Albumin(ALB)and Prothrombin Time(PT)level on preoperation between the two groups(all P > 0.05).The operation time of the extrahepatic Glisson pedicle group was significantly lower than that of the intrahepatic Glisson pedicle group(P < 0.05).There was no significant difference in intraoperative blood loss,postoperative ALT,AST,TBIL and ALB level on day 1,3 and 7,postoperative complication rate,postoperative drainage tube placement time,postoperative exhaust time and postoperative hospital stay between the two groups(P > 0.05).There was no perioperative death and no unplanned reoperation in both groups.Conclusion: Laparoscopic left hemihepatectomy with extrahepatic Glisson pedicle transection based on Laennec’s capsule theory is safe and feasible,and the operation time is significantly shorter than that of intrahepatic Glisson pedicle anatomical occlusion.The operation method based on Laennec’s capsule theory is not only beneficial to the operation,but also helps to standardize the procedure of anatomical hepatectomy.