Novel techniques of liver segmental and subsegmental pedicle anatomy from segment 1 to segment 8  

作　　者：Shao-Dong Wang Li Wang Heng Xiao Kai Chen Jia-Rui Liu Zhu Chen Xiang Lan 

机构地区：[1]Department of Hepatobiliary Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China [2]Department of Obstetrics and Gynecology,The Third Affiliated Hospital of Chongqing Medical University(General Hospital),Chongqing 401120,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第12期3806-3817,共12页世界胃肠外科杂志（英文）

基　　金：Supported by General Project of Natural Science Foundation of Chongqing,No.cstc2021jcyj-msxmX0604;Chongqing Doctoral“Through Train”Research Program,No.CSTB2022BSXM-JCX0045.

摘　　要：BACKGROUND Laparoscopic anatomical liver resection has become more challenging because some subsegmental Glissonean pedicles are hard to dissect.Here,we introduce how to dissect every(sub)segmental Glissonean pedicle from the first porta hepatis and perform standardized(sub)segmentectomy[from segment 1(S1)to S8].AIM To summarize our methods of laparoscopic anatomical segmental and subseg-mental liver resection.METHODS The Glisson sheath and liver capsule were separated along the Laennec mem-brane.The Glissonean pedicle could be isolated and transected with little or no parenchymal damage through this extra-Glissonean dissection approach.The basin of the(sub)segment was determined by the ischemia demarcation line or indocyanine green staining.The hepatic vein or intersegmental vein was also used to guide the plane of parenchymal transection.RESULTS All segmental or subsegmental pedicles or even the pedicle of the cone unit could be dissected along the Laennec membrane using our novel technique through the first porta hepatis.The dorsal branches of S8,the branches of S4a and the paracaval portion branches(b/c vein)of the caudate lobe were the most difficult to dissect.CONCLUSION The novel techniques of liver segmental and subsegmental pedicle anatomy is feasible for laparoscopic liver resection and can help accurately guide(sub)segmentectomy from S1 to S8.

关 键 词：Laparoscopic anatomical liver resection Subsegmentectomy Laennec membrane Liver pedicle anatomy Hepatocellular carcinoma 

分 类 号：R657.3[医药卫生—外科学]