Application of selfmade modified hepatic pedicle occluding band in laparoscopic special section hepatectomy

Objective To investigate the application value of selfmade modified hepatic pedicle occluding band in laparoscopic special section hepatectomy. Methods Forty-five patients who underwent laparoscopic special section hepatectomy in the Second Affiliated Hospital of Nanchang University between July 2014 and July 2015 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval was received. Among the patients, 17 were males and 28 were females with the age ranging from 28 to 71 years old and the median of 50 years old. Five cases underwent resection of segment Ⅳb, 8 of segment Ⅴ, 10 of segment Ⅶ, 9 of segment Ⅷ, 8 of segment Ⅵ+Ⅶ, and 5 of segment Ⅴ+Ⅶ. According to the random number table method, the patients were divided into the group of hepatic inflow occlusion with the selfmade modified hepatic pedicle occluding band (the modified group, n=18) and the traditional surgery group (the traditional group, n=27). Hepatic inflow was not occluded or was occluded by Pringle maneuver in the traditional group. The length of operation, intraoperative blood loss and postoperative length of stay in two groups were compared using t test. Results The patients in both groups completed the surgery successfully. No conversion to laparotomy was observed in the modified group, while the rate of conversion to laparotomy in the traditional group was 22%(6/27). The length of operation, intraoperative blood loss and postoperative length of stay in the modified group were respectively (226±95) min, (421±90) ml and (10±4) d, while those in the traditional group were respectively (286±95) min, (501±91) ml and (14±4) d, and significant differences were observed (t=-2.104, -2.899, -2.913; P<0.05). Conclusions The application of selfmade modified hepatic pedicle occluding band in laparoscopic special section hepatectomy is safe and feasible. And it can conveniently and effectively control the hepatic inflow. Key words: Laparoscopes; Hepatectomy; Hepatic artery; Blood occlusion