Comparison of three different methods for hepatic inflow occlusion in laparoscopic left lateral hepatic lobectomy
Objective: To compare the clinical effects of three different methods for hepatic inflow occlusion in laparoscopic left lateral hepatic lobectomy. Methods: The clinical data of 45 patients undergoing laparoscopic left lateral hepatic lobectomy for primary hepatocellular carcinoma during 2008 to 2015 were retrospectively analyzed. The intraoperative hepatic inflow control of the patients was performed by Pringle's maneuver (total hepatic occlusion group, 18 cases), hemihepatic vascular occlusion (hemihepatic occlusion group, 17 cases), and stepped occlusion of seven-step liver transection method (seven-step liver transection group, 10 cases). The major clinical variables among the three groups of patients were compared. Results: The intraoperative blood loss showed no statistical difference among the three groups (P>0.05), but the operative duration, postoperative liver function recovery, gastrointestinal functional recovery, incidence of postoperative complications and length of hospital stay in seven-step liver transection group were all significantly superior to those in total hepatic occlusion group and hemihepatic occlusion group (all P<0.05). Conclusion: Using seven-step method in laparoscopic left lateral hepatic lobectomy is safe, simple and feasible, with no special laparoscopic skill requirements for performers, so it is recommended to be used in hospitals of different levels.