Objective To assess the safety and feasibility of laparoscopic anatomical hepatectomy for segment Ⅷ using hepatic pedicle-first approach.Methods Thirteen patients with hepatocellular carci-noma undergoing laparoscopic anatomical hepatic segment Ⅷ resection at the Yantai Affiliated Hospital of Binzhou Medical University from January 2021 to May 2023 were enrolled,including 10 males and 3 females,aged(65±8)years old.During the operation,the hilar region was dissected to occlude the seg-mentⅧpedicle,the liver ischemic demarcation was obtained,and the liver parenchyma was transected trac-ing ischemic boundary.The methods of operation,operative time,intraoperative blood loss,postoperative complications and hospital-stay were retrospectively analyzed.Results Laparoscopic anatomical hepatic segment Ⅷ resection was successfully performed in 13 patients without conversion to laparotomy.Among them,the segment Ⅷ pedicle in five patients bifurcated from the right anterior Glisson pedicle near hilar region,while in other cases,segment Ⅷ pedicle originated in a deeper position,requiring partial transection of liver parenchyma.The operative time,intraoperative blood loss and postoperative hospital stay was(295.3±47.1)min,100.0(60.0,200.0)ml,and(7.1±1.2)d respectively.There was no intraopera-tive blood transfusion.One patient had postoperative biliary leakage,which was managed by drainage for 7 days,and other patients recovered uneventfully.Conclusion It is safe and feasible to perform laparoscopic anatomical segment Ⅷ resection using hepatic pedicle-first approach,which could be suitable for cases with segment Ⅷ pedicle originated from right anterior liver pedicle near hilar region.
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