Impacts of regional hepatic blood inflow occlusion on intraoperative bleeding and complications of laparoscopic hepatectomy for primary hepatic carcinoma
Impacts of regional hepatic blood inflow occlusion on intraoperative bleeding and complications of laparoscopic hepatectomy for primary hepatic carcinoma
Objective:To explore the impacts of regional hepatic inflow occlusion on intraoperative blood loss and complications of laparoscopic hepatectomy for primary hepatocarcinoma.Methods:A retrospective analysis was conducted on the clinical data of 106 primary hepatocarcinoma patients who underwent laparoscopic hepatectomy from Mar.2022 to Nov.2023.They were separated into two groups based on different blood flow blocking methods.Among them,52 patients who underwent total hepatic inflow occlusion(Pringle method)were regarded as the Pringle group,and 54 patients who underwent regional hepatic inflow occlusion were regarded as the regional group.Two groups were compared in terms of surgical indicators,changes in liver function indicators,hemodynamic indicators,and postoperative complications.Results:There were no significant differences in surgical time and hospital stay between the regional group and the Pringle group(P＞0.05),while the hepatic blood flow blocking time and intraoperative bleeding in the regional group were less than those in the Pringle group(P＜0.05).The inter-group,intra-group and interaction effects of total bilirubin,alanine amino-transferase,and aspartate aminotransferase between the two groups were statistically significant(P＜0.05).The three liver function indicators mentioned above were all higher than before surgery on the 1st day after surgery in each group(P＜0.05),the three liver function indicators on the 3rd and 7th day after surgery were lower than those on the 1st day after surgery(P＜0.05),and the regional group was lower than the Pringle group on the 1st,3rd,7th day after surgery(P＜0.05).On the 1st day after surgery,the mean arterial pressure of both groups was lower than that before operation(P＜0.05),and the heart rate was higher than that before operation(P＜0.05),however,there was no significant difference between the two groups(P＞0.05).There was no significant difference in the inci-dence of postoperative complications between the regional group and the Pringle group(P＞0.05).Conclusions:Compared with the Pringle method,using regional hepatic inflow occlusion during laparoscopic hepatectomy for primary hepatocarcinoma patients is benefi-cial in reducing hepatic blood flow blocking time and intraoperative bleeding,alleviating liver injury.
关键词
肝肿瘤/肝切除术/腹腔镜检查/区域性入肝血流阻断/出血量/并发症
Key words
Liver neoplasms/Hepatectomy/Laparoscopy/Regional occlusion of hepatic blood inflow/Bleeding volume/Compli-cations
维普
万方数据