Clinical Study On Laparoscopic Ultrasound-guided Hepatic Pedicle Ablation In Laparoscopic Anatomical Hepatectomy

Objective: To study the feasibility, security, technical points and clinical effect of laparoscopic ultrasound-guided hepatic pedicle ablation(HPA) in laparoscopic anatomical hepatectomy(LAH) by comparing the method with laparoscopic ultrasound-guided portal vein(PV) and hepatic vein(HV) branches detecting.Metheds: Retrospective analysis the clinical data of 27 patients who underwent LAH from Jun 2015 to Jan 2016. They were divided by group A(14 cases; laparoscopic ultrasound-guided PV and HV branches detecting) and group B(13 cases; laparoscopic ultrasonography-guided HPA). Comparisons between the groups in terms of age, gender, Child-Pugh level, operative time, blood loss, postoperative hospital stay,gastrointestinal function recovery time,the time for the first oral intake, liver function, postoperative complication rate etc.were performed. The comparison between groups was analyzed by t test and the count data was analyzed by chi-square(?2) test. The significance level for all tests was fixed at P<0.05. The statistical analyses were performed by SPSS 17.0 software.Results:The operation of LAH were successfully performed in the two groups and no deaths occurred.No significant difference was shown between the groups regarding age, gender, Child-Pugh level etc. There were significant differences between group A and group B in terms of operative time(157.4±31.3min vs 139.8±27.1min, t=9.876, P<0.05) and blood loss(241.1±121.5ml vs 149.7±88.4ml, t=12.342, P<0.05). The ALT and AST of group A was higher than group B in in the first day, the third day after surgery.(137.7±56.4U/L vs 106.1±42.9U/L, 86.4±32.4U/L vs 60.5±29.3U/L, 126.8±67.9U/L vs 107.7±86.5U/L, 82.3±30.5U/L vs 59.2±30.1U/L) The level of GGT of group A was lower than group B in the first day after surgery.(26.4±10.9U/L vs 33.5±16.5U/L). The differences were significant(P<0.05). Differences of the other clinical data between the groups were not statistically significant(P>0.05).Conclusions:1. The method of laparoscopic ultrasonography-guided hepatic pedicle ablation in laparoscopic anatomical hepatectomy is feasible and safe;2. The method of laparoscopic ultrasonography-guided hepatic pedicle ablation in laparoscopic anatomical hepatectomy has the advantages of less operative time and blood loss. The postoperative liver function recover faster.It is worth popularizing.