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

Turn off MathJax

Article Contents

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

PDF( 748 KB)

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

FullText(HTML)

References(27)

References

[1]	Rumgay H,Arnold M,Ferlay J,et al. Global burden of primary liver cancer in 2020 and predictions to 2040[J]. J Hepatol,2022,77(6):1598-1606. doi: 10.1016/j.jhep.2022.08.021
[2]	Zajkowska M,Mroczko B. Chemokines in primary liver cancer[J]. Int J Mol Sci,2022,23(16):8846. doi: 10.3390/ijms23168846
[3]	D'Silva M,Han H S,Yoon Y S,et al. Comparative study of laparoscopic versus open liver resection in gallbladder cancer[J]. J Laparoendosc Adv Surg Tech A,2022,32(8):854-859. doi: 10.1089/lap.2021.0670
[4]	Troisi R I,Berardi G,Morise Z,et al. Laparoscopic and open liver resection for hepatocellular carcinoma with Child-Pugh B cirrhosis: Multicentre propensity score-matched study[J]. Br J Surg,2021,108(2):196-204. doi: 10.1093/bjs/znaa041
[5]	马志勇. 腹腔镜精准肝切除治疗原发性肝癌的效果及术中出血量观察[J]. 中国药物与临床,2020,20(12):2025-2026.
[6]	Zhao H,Ding W Z,Wang H,et al. Prognostic value of precise hepatic pedicle dissection in anatomical resection for patients with hepatocellular carcinoma[J]. Medicine (Baltimore),2020,99(10):e19475.
[7]	中国抗癌协会肝癌专业委员会,中华医学会肝病学分会肝癌学组,中国抗癌协会病理专业委员会,等. 原发性肝癌规范化病理诊断指南(2015年版)[J]. 中华肝胆外科杂志,2015,21(3):145-151.
[8]	Li B,Liu T,Zhang Y,et al. Retroperitoneal laparoscopic hepatectomy of recurrent hepatocellular carcinoma: Case report and literature review[J]. BMC Gastroenterol,2020,20(1):278. doi: 10.1186/s12876-020-01380-2
[9]	Huang X,Wang J,Zhang J,et al. Ultrasound-guided erector spinae plane block improves analgesia after laparoscopic hepatectomy: A randomised controlled trial[J]. Br J Anaesth,2022,129(3):445-453. doi: 10.1016/j.bja.2022.05.013
[10]	陈志平,王岚枫. 精准肝切除术联合肝动脉化疗栓塞术对肝癌患者血清肿瘤标志物及肝功能的影响[J]. 医疗装备,2020,33(1):4-5.
[11]	Wang Z,Wang J,Liu G. Bridging the preoperative gap of precision hepatectomy: Superstable homogeneous iodinated formulation technology[J]. J Interv Med,2020,4(1):8-10.
[12]	Niu X,Liu J,Feng Z,et al. Short-term efficacy of precise hepatectomy and traditional hepatectomy for primary liver cancer: A systematic review and meta-analysis[J]. J Gastrointest Oncol,2021,12(6):3022-3032. doi: 10.21037/jgo-21-735
[13]	Zhang J,Zeng Q,Zhang P,et al. Efficacy evaluation and prognostic risk factors analysis of precise hepatectomy in the treatment of intermediate and advanced hepatocellular carcinoma[J]. Eur J Gastroenterol Hepatol,2023,35(1):120-126. doi: 10.1097/MEG.0000000000002460
[14]	Zhang J,Zhang P,Cao J. Safety and efficacy of precision hepatectomy in the treatment of primary liver cancer[J]. BMC Surg,2023,23(1):241. doi: 10.1186/s12893-023-02148-7
[15]	Chen H,He Y,Jia W. Precise hepatectomy in the intelligent digital era[J]. Int J Biol Sci,2020,16(3):365-373. doi: 10.7150/ijbs.39387
[16]	郭昊苏,刘宏,李凯,等. 肝切除在精准外科理念下治疗原发性肝癌近期疗效的荟萃分析[J]. 临床与病理杂志,2021,41(2):395-409. doi: 10.3978/j.issn.2095-6959.2021.02.023
[17]	Margonis G A,Vauthey J N. Precision surgery for colorectal liver metastases: Current knowledge and future perspectives[J]. Ann Gastroenterol Surg,2022,6(5):606-615. doi: 10.1002/ags3.12591
[18]	Shu C,Feng S,Cui Q,et al. Impact of Tai Chi on CRP,TNF-alpha and IL-6 in inflammation: A systematic review and meta-analysis[J]. Ann Palliat Med,2021,10(7):7468-7478. doi: 10.21037/apm-21-640
[19]	Zheng W,Tian X,Fan J,et al. Application of dexmedetomidine in surgical anesthesia for gastric cancer and its effects on IL-1β,IL-6,TNF-α and CRP[J]. Cell Mol Biol (Noisy-le-grand),2023,69(3):177-181. doi: 10.14715/cmb/2023.69.3.26
[20]	Amiral J,Busch M H,Timmermans S A M E G,et al. Development of IgG,IgM,and IgA autoantibodies against angiotensin converting enzyme 2 in patients with COVID-19[J]. J Appl Lab Med,2022,7(1):382-386. doi: 10.1093/jalm/jfab065
[21]	邓毅磊,梁志伟,杜帅,等. 乌司他丁对肝癌患者大范围肝切除术后肝功能保护作用的临床研究[J]. 中华普通外科杂志,2020,35(3):228-231.
[22]	Long H,Xu W,Zhong X,et al. Feasibility of liver stiffness measured using two-dimensional shear wave elastography in assessing preoperative liver function for patients with hepatocellular carcinoma[J]. Abdom Radiol (NY),2022,47(2):664-671. doi: 10.1007/s00261-021-03374-4
[23]	朱惠刚,刘东升,贾楷桥. 腹腔镜下精准肝切除术与常规腹腔镜肝肿瘤切除术治疗原发性肝癌的效果及安全性[J]. 中西医结合肝病杂志,2022,32(7):648-650.
[24]	孙莉,敬思懿. 腹腔镜精准肝切除术对原发性肝癌的近远期疗效及影响因素分析[J]. 北华大学学报(自然科学版),2023,24(2):231-235.
[25]	张乙川,李劲,徐杰,等. 精准肝切除术治疗单发肝癌伴微血管侵犯患者的疗效及术后切缘阳性的危险因素分析[J]. 国际外科学杂志,2021,48(7):444-451,F1.
[26]	林玲,俞善春,刘从瑶. 凝血四项及血清肿瘤标志物联合检测在乙型肝炎相关肝癌中的诊断价值[J]. 河北医科大学学报,2021,42(6):665-670.
[27]	Tang Y,Li K,Cai Z,et al. HSP90α combined with AFP and TK1 improved the diagnostic value for hepatocellular carcinoma[J]. Biomark Med,2020,14(10):869-878. doi: 10.2217/bmm-2019-0484

Relative Articles(20)

Relative Articles

[1]	Ying ZHANG, Fengxia YANG, Jing GUO, Qingling ZHANG. Effects of Systematic Psychological Intervention Based on S-ABC Framework on Perioperative Psychological Distress and Immune Function in Patients with Primary Liver Cancer. Journal of Kunming Medical University, 2023, 44(11): 170-174. doi: 10.12259/j.issn.2095-610X.S20231126
[2]	Ying ZHANG, Jing GUO, Tao FENG, Yan ZHOU, Yao HUANG, Xiao-feng DENG, LU ZHENG. Shared Decision-making in Patients with Primary Liver Cancer During Perioperative Period. Journal of Kunming Medical University, 2021, 42(8): 177-180. doi: 10.12259/j.issn.2095-610X.S20210832
[3]	Zhu Rong Song , Wei Xiao Ping , Dai Bin , Fan Hai Jun , Tan Yi Zheng , Fan Xue Rong , Tian Da Guang . . Journal of Kunming Medical University, 2019, 40(05): 68-72.
[4]	Xie Qing Yun , Lei Ze Hua , Gao Feng Wei , Jiang Kang Yi . . Journal of Kunming Medical University, 2018, 39(10): 101-104.
[5]	Zhou Wen Jing , Liu Jun , Bai Jing Song , Tian Bo , Jin Yong Mei , Tao Jian , Li Zhong Xi , Chen Jian Hua . Correlation between Hepatic Pathohistology of Biopsies and Clinical Indices in Patients with HIV/HCV Co-infection. Journal of Kunming Medical University, 2017, 38(06): 136-139.
[6]	Gao Jing Yan , Chen Fu Kun , Yan Jia Wen , Wang Jia Ping . Clinical Analysis of Transcatheter Arterial Chemoembolization Combined with Intensity Modulated Radiotherapy Therapy for Patients with Primary Hepatic Carcinoma. Journal of Kunming Medical University, 2017, 38(01): 95-98.
[7]	Wang Biao . Analysis of Liver Function of Type 2 Diabetic Rats Induced by Fat Diet and STZ. Journal of Kunming Medical University,
[8]	Li Yue Hua . . Journal of Kunming Medical University,
[9]	Yang Jing . . Journal of Kunming Medical University,
[10]	Sun De Yun . . Journal of Kunming Medical University,
[11]	Qin Xing Lu . . Journal of Kunming Medical University,
[12]	Ren Ai Hong . . Journal of Kunming Medical University,
[13]	Yan Jun Ling . . Journal of Kunming Medical University,
[14]	Gu Xin . . Journal of Kunming Medical University,
[15]	Xiao Zhong Xian . . Journal of Kunming Medical University,
[16]	Xu Jing . Study of Heterografting of Microliver Slice in Rats with Fulminant Hepatic Failure. Journal of Kunming Medical University,
[17]	. Application Value of Precise Hepatectomy in Liver Surgery. Journal of Kunming Medical University,
[18]	. Therapeutic Effect of Transcatheterhepatic Arterial Chemoembolization(TACE)Combined with Operation on 96 Cases of Primary Hepatic Carcinoma. Journal of Kunming Medical University,
[19]	. . Journal of Kunming Medical University,
[20]	Hao Jin Gang . . Journal of Kunming Medical University,