Clinical Analysis Of Modified Laparoscopic Hepatectomy For Hemangioma In Right Lobe Of Liver

Objective:Liver hemangioma is the most common benign tumor involving the liver.At present,the resection of hepatic hemangioma is the most effective treatment for hepatic hemangioma.Since the successful application of laparoscopic technique by Reich in 1991,more and more liver surgeries have been performed under laparoscopy.As the incisions are much smaller than their open counterparts,recovery is faster and post-operative pain is typically less.Minimally invasive surgery has been widely accepted as a conventional surgery for liver surgery.However,due to the special anatomical features of the liver,especially for the tumor in the right lobe of the liver,the operation space is narrow,and the exposure and hemostasis is relatively difficult.Laparoscopic liver surgery has a high demand for operator.which restricts the popularization of laparoscopic technique in the Department of Hepatobiliary Surgery.The purpose of this study was to investigate the feasibility and safety of laparoscopic surgery for the treatment of right hepatic lobe hemangioma,and to summarize the experience and skills of laparoscopic surgery in our department.Materials and Methods:According to the inclusion criteria and exclusion criteria of this retrospective research,data of 60 cases of liver surgery for the treatment of right lobe hemangioma from November 2012 to September 2016 in Qilu Hospital of Shandong University were collected.All patients were diagnosed by imaging before operation.All patients had normal coagulation function,liver function and AFP before operation.Investigating the feasibility and safety of laparoscopic surgery for the treatment of right hepatic lobe hemangioma were through the analysis of operation time,intraoperative blood loss,intraoperative blood transfusion,hepatic portal occlusion time,perioperative liver function,indwelling abdominal drainage tube time,postoperative complications,postoperative hospital stay.Results:All patients were performed under laparoscopy,and none of them were converted to laparotomy.The average operation time was(141 + 33.6)min,the average intraoperative blood loss was(168.7 + 129.8)ml the average hepatic portal occlusion time was(21.5 + 7.2)min,there was no intraoperative and postoperative blood transfusion,the average indwelling abdominal drainage tube time was(5.8 +2.2)d,the average postoperative hospital stay was(10 + 2.3)d.There was no severe complications such as massive hemorrhage,biliary fistula.All patients were discharged smoothly.Conclusion:By analyzing the clinical data of 60 cases,we can find that the laparoscopic technique has a good effect and safety in the treatment of liver hemangioma in the right lobe.Our modified laparoscopic technique can greatly reduce the difficulty of the resection of hepatic hemangioma and the risk of operation,so that the laparoscopic resection of hepatic hemangioma can be completed safely and effectively.It should be applied extensively in clinic in the future.With regard to the hepatic hemangioma distributed in the right posrerior lobe of liver,laparoscopic hepatectomy should be considered a safe and effective surgical method under thorough preoperotive assessment and appropriate case choice.