Application Of Non-blood Flow Occlusion Technique In Laparoscopic Left External Hepatic Lobectomy

Objective: To study the feasibility and effect of non-blood flow occlusion technique in laparoscopic left lateral hepatic lobectomy.In this study,the non-blood flow occlusion method was compared with the traditional first portal blood occlusion method(Pringle method),and relevant clinical data of the two surgical methods were collated and analyzed,so as to systematically evaluate the safety,effectiveness,feasibility and application advantages of non-blood flow occlusion technique in laparoscopic left lateral hepatic lobectomy.Methods: The clinical data of patients who underwent laparoscopic left lateral hepatectomy in the Department of Hepatobiliary Surgery of Youjiang Medical College for Nationalities and the Department of Hepatobiliary and Pancreatic Surgery of Baidong District from September 2018 to January 2023 were retrospectively studied,and the preoperative and postoperative data of all patients were statistically analyzed.According to different surgical methods,the collected case data were divided into:(1)observation group: laparoscopic left lateral hepatectomy without blood flow occlusion group;(2)Control group: laparoscopic left lateral hepatic lobectomy group with Pringle blood flow occlusion.The general data of the two groups before surgery were analyzed and compared:(1)age,gender,BMI,preoperative alanine aminotransferase,aspartate aminotransferase,total bilirubin,albumin,total protein,prothrombin time and other liver function indexes.(2)Intraoperative data: operation time,blood loss,blood transfusion,etc.;(3)Postoperative data: alanine aminotransferase,aspartate aminotransferase,total bilirubin,albumin,total protein,prothrombin time on postoperative day 1,3 and 7,abdominal drainage tube indwelling time,gastrointestinal function recovery time,hospital stay,postoperative bile leakage,abdominal bleeding,infection and other postoperative complications.SPSS22.0 statistical software was used to record and analyze the data.Results: Through data analysis,there were no statistical differences in preoperative age,gender,BMI,preoperative alanine aminotransferase,aspartate aminotransferase,total bilirubin,albumin,total protein,prothrombin time and other liver function indicators between the two groups.Compared with the non-blood flow occlusion group,there was no significant difference in operation time and blood loss between the two groups(P>0.05).We found that the recovery degree of liver function in the non-blood flow occlusion group was faster at 1and 3 days after operation(P<0.05),which was especially obvious in patients with cirrhosis.There was no significant difference in postoperative complications between the two groups.Conclusion:Laparoscopic left lateral lobectomy without blood flow occlusion is safe and feasible.Compared with Pringle’s method,the patients’ liver function recovered more quickly after operation,and there was no significant difference in the amount of blood loss during laparoscopic left lateral lobectomy.The procedure of laparoscopic left lateral lobectomy without blood flow occlusion is more simple,it shortens the operation time to a certain extent,has little influence on liver function,and the patients recover quickly after operation.