关键词: 原发性肝癌, 入肝血流阻断, 腹腔镜肝切除术, 并发症, 治疗

Abstract: Objective The aim of this study was to investigate different hepatic inflow occlusion techniques during laparoscopic hepatectomy (LH) in treatment of patients with primary liver cancer (PLC). Methods A total of 132 patients with PLC were encountered in our hospital between February 2021 and November 2022, and all underwent LH. They were divided into observation (n=69), and control group (n=63), received regional hepatic inflow occlusion or intermittent total hepatic inflow occlusion during LH. The heart rate (HR) and mean arterial pressure (MAP) were routinely measured, and the portal vein peak velocity (VPV) was detected by ultrasonography. Results There was no significant differences as respect to blood transfusion rate, operation time and hospitalization stay [15.9%, (240.3±42.9) min and (14.7±2.3) d vs. 19.1%, (231.7±39.5) min and (15.0±2.9) d, P>0.05] between the observation and control group, while the hepatic flow occlusion time in the observation group was significantly shorter than that in the control group [(0.0±0.0) min vs. (26.8±7.1) min, P<0.05], and the intraoperative blood loss was significantly less than that in the control group [(301.2±52.5) mL vs. (369.8±59.4) mL, P<0.05]; there was no significant differences between the two groups respect to the HR, MAP and PVV [(79.1±7.2) beats/min, (80.7±3.6) mmHg and (21.3±2.0) cm/s vs. (78.9±6.8) beats/min, (81.9±4.1) mmHg and (20.9±1.9) cm/s, P>0.05] at day seven after surgery; serum total bilirubin level in the observation group was significantly lower than that in the control group [(18.4±3.5) μmol/L vs, (24.9±5.7) μmol/L, P<0.05], while serum albumin level was significantly higher than that in the control group [(35.3±5.4) g/L vs. (32.0±4.6) g/L, P<0.05]; all patients were followed-up for 1 month after surgery, and there was no significant difference between the two groups as respect to the incidence of ascites, incision infection, bile leakage, pulmonary infection and abdominal bleeding(2.9% vs. 3.2%, P＞0.05). Conclusion The two hepatic inflow occlusion techniques are both safe and effective during the LH operation, but the measure by regional hepatic inflow occlusion could shorten occlusion time and reduce intraoperative blood loss, and decrease the postoperative liver function injury.

Key words: Hepatoma, Laparoscopic hepatectomy, Hepatic inflow occlusion, Complication, Therapy