Abstract:

Objective

To compare the short- and medium-term curative effects of hepatectomy with different inflow blood flow occlusion of the liver under laparoscopy in the treatment of primary liver cancer (PLC).

Methods

The clinical data of 115 patients who underwent laparoscopic hepatectomy for PLC from March 2021 to September 2023 were collected. According to different methods of intraoperative inflow blood flow occlusion of the liver, the patients were divided into group A (intermittent blood flow occlusion, n=57 cases) and group B(regional blood flow occlusion, n=58 cases). The statistical software SPSS 25.0 was used for data processing.The perioperative indexes, liver function indexes, tumor markers, etc. were expressed as (), and a t test was used. The levels of liver function and tumor markers were examined by general linear repeated measures analysis of variance. The incidence of postoperative complications was compared by the chi-square test.

Results

The intraoperative blood loss in group B was less than that in group A (P<0.05). The time of the first exhaust, eating, and defecation after surgery in group B was shorter than that in group A (P<0.05). Seven days after surgery, the levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in both groups were higher than those before surgery, but the levels in group B were lower than those in group A. The levels of cholinesterase (ChE) in both groups decreased, but the levels in group B were higher than those in group A (P<0.05).One month after surgery, the levels of AST and ALT in both groups were lower than those before surgery and 7 days after surgery, and the level of ChE was higher than that before surgery and 7 days after surgery (P<0.05).One month after surgery, there was no statistically significant difference in the levels of AST, ChE, and ALT between group A and group B (P>0.05). One month and 12 months after surgery, the levels of alpha-fetoprotein(AFP) and carcinoembryonic antigen (CEA) in both groups were lower than those before surgery (P<0.05), but there was no statistically significant difference in the levels of AFP and CEA between group A and group B one month and 12 months after surgery (P>0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (P>0.05).

Conclusion

Compared with the intermittent inflow blood flow occlusion method of the liver, the application of the regional inflow blood flow occlusion method of the liver in laparoscopic hepatectomy can reduce the intraoperative blood loss and has less impact on the gastrointestinal function and liver function of patients. However, the safety of the two methods and their impacts on the oncological effects are similar.

Key words: Primary Liver Cancer, Hepatectomy, Laparoscopes, Regional Hepatic Blood Flow Blockade, Intermittent Hepatic Blood Flow Blockade