title: An Improved Surgical Technique for Pure Laparoscopic Left Hemihepatectomy: Ten Years Experience in a Tertiary Center.
abstract: BACKGROUND
  This study details our experience with an improved surgical technique involving the hepatic pedicle during laparoscopic left hemihepatectomy (LLH).
  
  
  METHODS
  We describe an improved laparoscopic technique to extraparenchymally divide the left hepatic pedicle. A retrospective analysis of all of the patients who underwent laparoscopic liver procedures between 2002 and 2012 was conducted. The patients were divided into two groups, an early LLH group (ELLH group) and a recent LLH group (RLLH group), based on the surgical approach used for the left hepatic pedicle.
  
  
  RESULTS
  A total of 72 cases of LLH (26 ELLH and 46 RLLH) were identified. The RLLH group exhibited a shorter median operative time, median length of hospital stay, and lower median blood loss compared to the ELLH group (182, 162.5-223.7 versus 232.5, 200-357.5 minutes, P < .01; 5, 4.2-7 versus 7, 6-8.7 days, P < .05; 150, 100-257.5 versus 300, 200-337.5 mL, P < .05, respectively). No perioperative mortality was observed.
  
  
  CONCLUSIONS
  This study confirms that our improved surgical technique for LLH is practical, safe, and effective. The main advantage of this method compared to other techniques is the possibility of attaining rapid and precise control of vascular inflow, thus facilitating LLH.
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .|2 Emergency Department, Chinese PLA Navy General Hospital , Beijing, China .
authors: Xuefei
authors: X
authors: Wang
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
authors: Minggen
authors: M
authors: Hu
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
authors: Zhiming
authors: Z
authors: Zhao
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
authors: Chenggang
authors: C
authors: Li
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
authors: Guodong
authors: G
authors: Zhao
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
authors: Yong
authors: Y
authors: Xu
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
authors: Dabin
authors: D
authors: Xu
authors: 1 Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army (PLA) General Hospital , Beijing, China .
authors: Rong
authors: R
authors: Liu
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000601:surgery*; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000601:surgery*; D006391:Hemangioma / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: hemihepatectomy; hepatic pedicle; laparoscopic liver resection; major liver resection; minimally invasive surgery; oncological surgery