Standardization of pure laparoscopic extended cholecystectomy with en-bloc lymphadenectomy of the hepatoduodenal ligament for gallbladder cancers.
Asian J Endosc Surg
; 16(3): 662-665, 2023 Jul.
Article
en En
| MEDLINE
| ID: mdl-37394286
ABSTRACT
BACKGROUND:
Application of laparoscopic liver resection (LLR) for gallbladder cancers (GBC) has been approved by the Japanese national health insurance system since 2022. However, there are few reports describing LLR techniques for GBCs. We herein report pure laparoscopic extended cholecystectomy with en-bloc lymphadenectomy of the hepatoduodenal ligament for clinical T2 GBC patients. MATERIALS AND SURGICAL TECHNIQUE We performed this procedure for five clinical T2 GBC patients from September 2019 to September 2022. Under general anesthesia and usual set-up for LLR, the caudal line of the hepatoduodenal ligament is transected and the lesser omentum is opened. The right and left hepatic arteries are skeletonized and taped while dissected lymph nodes being dissected toward the hilar side. Then, the common bile duct is taped and the portal vein dissecting the lymph nodes toward the gallbladder. After completing skeletonization of the hepatoduodenal ligament, the cystic duct and the cystic artery are clipped and divided. Hepatic parenchymal transection is performed employing Pringle's maneuver and crush-clamp technique, the same as usual LLR. We perform gallbladder bed resection with surgical margin of 2-3 cm from the gallbladder bed. The mean operating time and blood loss were 151 minutes and 46.4 mL, respectively. There was one case of bile leakage requiring endoscopic stent placement.DISCUSSION:
We successfully established pure laparoscopic extended cholecystectomy with en-bloc lymphadenectomy of the hepatoduodenal ligament for clinical T2 GBC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Colecistectomía Laparoscópica
/
Laparoscopía
/
Neoplasias de la Vesícula Biliar
Límite:
Humans
Idioma:
En
Revista:
Asian J Endosc Surg
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón