Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic Anatomical Segment VII Resection for Hepatocellular Carcinoma Using the Glissonian Approach with Indocyanine Green Dye Fluorescence

  • Multimedia Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Many studies confirm that anatomical resection was associated with favorable oncologic outcomes for patients with HCC who had preserved as much of the remnant liver tissue as possible.1,2 In recent years, laparoscopic liver resection has been widely extended from minor resection to complex hepatectomy,3 However, surgery on tumors located in the posterosuperior segment remains a demanding procedure regardless of the extent of resection.4 Laparoscopic anatomical segment VII resection has one of the highest difficulty scores based on the tumor location due to poor accessibility, hard to exposure, and difficulty in obtaining sufficient surgical margins.5,6 Here, we report a totally laparoscopic anatomical VII resection using the Glissonian approach with indocyanine green dye fluorescence.

Methods

A 74-year-old man with a body mass index of 31.9 kg/m2 suffered from HBV-related cirrhosis was admitted to our institution. The preoperative Gd-EOB-DTPA MRI showed a 2.7-cm HCC located in segment VIII. The preoperative AFP is 3431 ng/ml. A true anatomical segmentectomy was performed by using selective occlusion of segment VII Glissonian pedicle, which was identified from the liver hilum. Indocyanine green (ICG) dye demarcation was used as a guidance during parenchymal transection.

Results

The operative time was 270 min with an estimated blood loss of 200 mL. The postoperative course was uneventful. Drainage tube was pulled out on the fourth day. The pathology confirmed the diagnosis of hepatocellular carcinoma and the surgical margin was negative. The patient was discharged on the 8th day after operation.

Conclusions

Totally laparoscopic anatomical segment VII resection is a technically challenging operation. Advanced laparoscopic skills are necessary to complete such a difficult procedure safely. Glissonian approach and ICG fluorescence imaging guide parenchyma resection could be help.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hasegawa K, Kokudo N, Imamura H, Matsuyama Y, Aoki T, Minagawa M, Sano K, Sugawara Y, Takayama T, Makuuchi M. Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg. 2005 ;242(2):252–9

    Article  Google Scholar 

  2. Kaibori M, Kon M, Kitawaki T, Kawaura T, et al. Comparison of anatomic and non-anatomic hepatic resection for hepatocellular carcinoma. J Hepatobiliary Pancreat Sci. 2017 ;24(11):616–626

    Article  Google Scholar 

  3. Wakabayashi G, Cherqui D, Geller DA, et al. Practical guidelines for performing laparoscopic liver resection based on the second international laparoscopic liver consensus conference. Surg Oncol.2018;27(1):A5–A9

    Article  Google Scholar 

  4. Ishizawa T, Gumbs AA, Kokudo N, Gayet B. Laparoscopic segmentectomy of the liver: from segment I to VIII. Ann Surg 2012;256(6):959–964

    Article  Google Scholar 

  5. Ban D, Tanabe M, Ito H, Otsuka Y, Nitta H, Abe Y, Hasegawa Y, Katagiri T, Takagi C, Itano O, Kaneko H, Wakabayashi G .A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci .2014;21(10):745–753

    Article  Google Scholar 

  6. Kazaryan AM, Rosok BI, Marangos IP, Rosseland AR, Edwin B. Comparative evaluation of laparoscopic liver resection for posterosuperior and anterolateral segments. Surg Endosc.2011;25 12.:3881–3889

    Article  Google Scholar 

Download references

Funding

This study was supported by a grant from the Guangdong Provincial Health and Family Planning Commission (No. A2016069).

Author information

Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Guangdong Province Traditional Chinese Medical Hospital, No. 111, Dade road, Yuxiu District, Guangzhou, 510120, People’s Republic of China

    Jun-ming He, Zhi-peng Zhen, Qing Ye, Jia-qiang Mo, Gui-hao Chen & Jian-xin Peng

Authors
  1. Jun-ming He
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhi-peng Zhen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qing Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jia-qiang Mo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gui-hao Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jian-xin Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jian-xin Peng.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(MP4 475 mb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

He, Jm., Zhen, Zp., Ye, Q. et al. Laparoscopic Anatomical Segment VII Resection for Hepatocellular Carcinoma Using the Glissonian Approach with Indocyanine Green Dye Fluorescence. J Gastrointest Surg 24, 1228–1229 (2020). https://doi.org/10.1007/s11605-019-04468-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-019-04468-7

Keywords

Search

Navigation