关键词: 分层法,  ,  ,  , 腹腔镜左外叶肝切除,  ,  ,  , 解剖学

Abstract:

Objective　To investigate the anatomical structure of the left lateral lobe, and to compare the differences between “the two-step separation approach” and the traditional method in laparoscopic left lateral sectionectomy(LLLS).  Methods  We retrospectively analyzed the clinical data and imaging information of 46 cases of laparoscopic left lateral lobectomy with "no fissure the falciform ligament of liver using two-step separation approach" from June 2014 to April 2017 in our hospital. Statistical analysis was performed for comparison data to patients with traditional laparoscopic left lobectomy before 2014.　Results  There was no significant difference between the two groups in gender, age, course of disease, location and size of tumor, preoperative liver function, liver reserve function (P>0.05); intraoperative blood loss, postoperative hospitalization time of patients in the two groups were close, and there was no significant difference between the two groups (P>0.05) . The duration of operation in “the two-step separation approach” group was significantly shorter than that in the control group (P<0.05).　Conclusion　The modified “The two-step separation approach” in laparoscopic left lateral hepatectomy does not involve severance of falciform ligament, thus circumventing unnecessary operation, and reducing the operation time; The method is easy to learn and has become the gold standard for left lateral hepatectomy when taking into account the development of laparoscopic techniques.

Key words: The two-step separation approach, 　Laparoscopic left lateral sectionectomy, 　 Anatomical structure