Effect of Precise Hepatic Pedicle Dissection Assisted Laparoscopic Hepatectomy and Its Impact on Inflammatory Immune Stress and Liver Function

Lei CHEN; Tong TANG; Daizhong ZHANG; Fengling LIU; Zhongqiu YANG; Huan YAN

doi:10.12259/j.issn.2095-610X.S20240417

Volume 45 Issue 4

Apr. 2024

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Article Navigation > Journal of Kunming Medical University > 2024 > 45(4): 120-127

Lei CHEN, Tong TANG, Daizhong ZHANG, Fengling LIU, Zhongqiu YANG, Huan YAN. Effect of Precise Hepatic Pedicle Dissection Assisted Laparoscopic Hepatectomy and Its Impact on Inflammatory Immune Stress and Liver Function[J]. Journal of Kunming Medical University, 2024, 45(4): 120-127. doi: 10.12259/j.issn.2095-610X.S20240417

Citation:

Lei CHEN, Tong TANG, Daizhong ZHANG, Fengling LIU, Zhongqiu YANG, Huan YAN. Effect of Precise Hepatic Pedicle Dissection Assisted Laparoscopic Hepatectomy and Its Impact on Inflammatory Immune Stress and Liver Function[J]. Journal of Kunming Medical University, 2024, 45(4): 120-127. doi: 10.12259/j.issn.2095-610X.S20240417

Citation:

Lei CHEN, Tong TANG, Daizhong ZHANG, Fengling LIU, Zhongqiu YANG, Huan YAN. Effect of Precise Hepatic Pedicle Dissection Assisted Laparoscopic Hepatectomy and Its Impact on Inflammatory Immune Stress and Liver Function[J]. Journal of Kunming Medical University, 2024, 45(4): 120-127. doi: 10.12259/j.issn.2095-610X.S20240417

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Effect of Precise Hepatic Pedicle Dissection Assisted Laparoscopic Hepatectomy and Its Impact on Inflammatory Immune Stress and Liver Function

doi: 10.12259/j.issn.2095-610X.S20240417

1.
Dept. of General Surgery
2.
Dept. of Hepatobiliary and Pancreatic Surgery，Dazhou Central Hospital ，Dazhou Sichuan 635000，China

Received Date: 2023-12-01
Available Online: 2024-04-03
Publish Date: 2024-04-29

Abstract

Abstract

Objective To explore the effect of precise liver pedicle dissection technique assisted laparoscopic hepatectomy on inflammatory immune stress and liver function. Methods A total of 114 patients with primary liver cancer in Dazhou Central Hospital from October 2019 to June 2022 were selected and divided into 57 patients each according to random number table method. Both groups underwent laparoscopic hepatectomy for liver cancer. The conventional group underwent routine liver resection, while the precision group underwent precise liver pedicle dissection. The surgical indicators, inflammatory-immune indicators [interleukin-6 （IL-6）, C-reactive protein （CRP）, tumor necrosis factor-α （TNF-α）, immunoglobulin A （IgA）, IgM, IgG], liver function [alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, γ-glutamyltranspeptidase （γ-GT）, total bilirubin （TBIL）], tumor factors [alpha-fetoprotein （AFP）, carbohydrate antigen 19-9 （CA19-9）, thymidine kinase 1 （TK1）], complication rate were compared between the two groups, and follow-up was conducted for 1 year. The recurrence rate and survival rate were statistically analyzed for both groups. Results There was no significant difference in operation time and positive rate of resection margin between the two groups （P > 0.05）. The intraoperative blood loss and postoperative drainage volume in the precision group were less than those in the conventional group, and the postoperative extubation time and hospital stay were shorter than those in the conventional group （P < 0.05）. After 1 day, 3 days, and 7 days post-operation, the levels of serum IL-6, CRP, TNF-α, ALT, AST, γ-GT, and TBIL showed a decreasing trend after an initial increase. The precision group had lower levels compared to the standard group. The serum levels of IgA, IgM, and IgG showed an increasing trend after an initial decrease, with the precision group having higher levels than the standard group （P < 0.05）. After 3 months, the serum levels of AFP, CA19-9, and TK1 were lower than pre-operation levels, with the precision group showing lower levels compared to the standard group （P < 0.05）. The precision group had a lower complication rate of 5.26% （3/57） compared to the standard group's 17.54% （10/57）（P < 0.05）. During a 1-year follow-up, 2 cases were lost to follow-up in the precision group, while 1 case was lost in the standard group. The precision group had a recurrence rate of 25.45% （14/55） after 1 year, lower than the standard group's 44.64% （25/56）, with a survival rate of 85.45% （47/55） higher than the standard group's 62.50% （35/56）（P < 0.05）. Conclusion The application of precise liver pedicle dissection techniques in laparoscopic hepatectomy for primary liver cancer can optimize surgical conditions, reduce inflammatory immune stress and liver function injury, reduce complications, significantly inhibit tumor factor expression, reduce recurrence rate, and improve survival rate.
- Primary liver cancer,
- Laparoscopic hepatectomy,
- Precise liver pedicle dissection technique,
- Liver function,
- Inflammatory immune stress response

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