Glisson蒂鞘外解剖性肝切除对原发性肝癌患者手术指标及肝功能的影响OA

Objective To investigate the influences of Glisson pedicle sheath external anatomical hepatectomy(AR)on the surgical parameters and liver function in patients with primary liver cancer(PLC).Methods The clinical data of 128 PLC patients who underwent laparoscopic selective hepatectomy via Glisson pedicle sheath in Qingdao Traditional Chinese Medicine Hospital from August 2019 to August 2022 were retrospectively analyzed.According to different methods of intraoperative hepatic blood flow blockade,they were divided into external anatomical group(n=61,external anatomical route operation was performed)and internal anatomical group(n=67,internal anatomy route was performed).SPSS 22.0 software was used to match patients with 1∶1 tendency score(PSM),and 48 patients in each group were finally included in this study.The operation indexes,liver function(total bilirubin,glutamic pyruvic transaminase,glutamic oxaloacetic transaminase)and postoperative complications were compared between the two groups.Results The operation time of external anatomy group(186.29±39.61)min was shorter than that of internal anatomy group(227.83±41.07)min(P<0.05),and the intraoperative blood loss(317.0±74.0)mL was less than that of internal anatomy group(351.2±78.4)mL(P<0.05);there were significant differences in the intersubject effect comparison of total bilirubin,glutamic pyruvic transaminase and glutamic oxaloacetic transaminase levels(P<0.05),significant differences in the main effect comparison between time points(P<0.05),and interaction between groups and time points(P<0.05).GPT,GOT and TBiL levels in two groups were higher than those before surgery 1 day and 1 week after surgery(P<0.05).However,the three liver function indexes of the external anatomy group were significantly lower than those of the internal anatomy group one day and one week after surgery(P<0.05);the incidence of postoperative complications in the external anatomy group was 4.17%,which was obviously lower than that in the internal anatomy group(18.75%,P<0.05).Conclusions The application of Glisson pedicle sheath external AR in PLC patients has the advantages of shorter operation time,less intraoperative blood loss,fewer postoperative complications,and faster recovery of liver function compared with the internal anatomical path.