腹腔镜左半肝切除术中不同肝血流阻断方式对患者短期预后的影响OA

Objective To comparatively analyze the effects of different hepatic vascular occlusion techniques on perioperative parameters and postoperative complication rates in laparoscopic left hemihepatectomy.Methods A retrospective analysis was conducted on clinical data from 95 patients who underwent laparoscopic left hemihepatectomy at the Affiliated Hospital of Inner Mongolia Medical University between October 2015 and October 2025.Patients were divided into four groups according to the method of hepatic blood flow occlusion:Pringle maneuver group(n=25),intrathecal Glisson's pedicle transection group(n=23),intrathecal Glisson's pedicle transection combined with left hepatic veins exclusion group(n=23),and extrathecal Glisson's pedicle transection group(n=24).The following parameters were compared among the four groups:operation time,intraoperative blood loss,serum levels of total bilirubin(TBIL),glucose(GLU),alanine aminotransferase(ALT),aspartate aminotransferase(AST),white blood cells(WBC),platelets(PLT),and albumin(ALB)at 1 week postoperatively,as well as incidence rates of postoperative complications.Results Compared with the other three groups,the Pringle maneuver group demonstrated significantly longer operation time,more intraoperative blood loss,elevated TBIL,ALT,AST,and WBC levels,as well as reduced PLT and ALB levels(P<0.05).The extrathecal Glisson's pedicle transection group showed superior outcomes in terms of operation time,intraoperative blood loss,and all measured serum indicators compared with the other three groups(P<0.05).No statistically significant differences were observed in the incidence rates of biliary fistula,abdominal infection,pulmonary infection or pyoperitoneum among the four groups(P>0.05).However,the overall complication rate differed significantly among the four groups(P<0.05),with extrathecal Glisson's pedicle transection group exhibiting the lowest overall complication rate,which was significantly better than the other three groups(P<0.05).Conclusion Compared with the Pringle maneuver,intrathecal Glisson's pedicle transection,intrathecal Glisson's pedicle transection combined with left hepatic veins exclusion,extrathecal Glisson's pedicle transection can effectively control operative duration and intraoperative hemorrhage during laparoscopic left hemihepatectomy,improve liver function recovery,attenuate inflammatory responses,reduce postoperative complication rates,and demonstrate high feasibility for clinical application.