Clinical Research On The Application Of Controlled Low Central Venous Pressure During Laparoscopic Hepatectomy In Elderly Patients With Primary Liver Cancer

Objective:To investigate and analyze the clinical effects of controlled low central venous pressure(CLCVP)applied during laparoscopic hepatectomy(LH)in elderly patients with primary hepatocellular carcinoma and the associated factors affecting their prognosis.Methods:From January 2020 to December 2022,111 patients over the age of 60 who underwent laparoscopic hepatectomy for primary liver cancer at Jilin University’s first hospital’s second department of Hepatobiliary and pancreatic surgery were studied retrospectively.The patients were divided into two groups based on whether controlled low central venous pressure(CLCVP)or normal central venous pressure(NCVP)was used intraoperatively,with 50 cases in the CLCVP group and 61 cases in the NCVP group.The patients were divided into two groups: CLCVP and normal central venous pressure(NCVP),with 50 in the CLCVP group and 61 in the NCVP group.There were totals for the preoperative,intraoperative,and postoperative data from the two groups.Depending on the size and location of the tumor,each group received the appropriate treatment regimen.The total amount of hepatic portal blocks,their duration,intraoperative operative time,and intraoperative hemorrhage were also compared between the two groups intraoperatively.On postoperative days 1 and 3,patients’ levels of the enzymes glutathione transaminase(ALT),glutathione aminotransferase(AST),total bilirubin,direct bilirubin,creatinine,and urea nitrogen were compared.For statistical analysis,SPSS 26.0 was used,and the count data were analyzed using the chisquare test,with a p-value cutoff of 0.05 for statistically significant differences.Results:The 111 senior patients with primary liver cancer gathered ranged from 60 to82 years of age,with a male to female ratio of 1.92:1.There was no statistically significant difference between the two groups(P > 0.05).Intraoperative data showed that the CLCVP group required less time to complete the procedure than the NCVP group did,and they lost less blood as well.Postoperative data: There was no statistically significant difference in renal function between the two groups(P > 0.05),while Alt and AST levels in the CLCVP group were lower than those in the NCVP group on postoperative days 1 and 3(p 0.001).Between the two groups,there was no discernible difference in postoperative days in hospital(P > 0.05).Conclusion:After a proper portal vein occlusion during laparoscopic hepatectomy in elderly patients,the use of the controlled low central venous pressure(CLCVP)technique can lessen intraoperative blood loss and transfusion rates,speed up the procedure,and hasten the recovery of liver function.Both surgical complications and renal function were unaffected significantly.The results of this study show that CLCVP can decrease postoperative liver injury by lowering blood loss,procedure time,and hepatic portal occlusion duration,which is advantageous for the restoration of liver function.CLCVP is a safe,manageable,and efficient intraoperative supplementary treatment for older patients with HCC,and it has no appreciable adverse effects on postoperative sequelae including liver and kidney damage.Therefore,using the CLCVP approach when operating on older patients is essential and clinically useful.