DUAN Yi-tao,ZHENG Bai-jun,GAO Ya,et al.Laparoscopic liver resection in children: a report of 4 cases[J].Journal of Clinical Pediatric Surgery,,12():110-112.[doi:10.3969/j.issn.1671— 6353.2013.02.010]
Laparoscopic liver resection in children: a report of 4 cases
- Keywords:
- Laparoscopes; Hepatectomy; Child
- Abstract:
- Objetive Laparoscopy for the resection of liver masses in children has remained undeveloped despite the wide acceptance of laparoscopy in the field of adult liver surgery.The authors report 4 cases of nonanatomical or anatomical laparoscopic hepatic resection of children. Methods Four to five trocars were placed. Pneumoperitoneum was established and maintained at 10~12 mmHg during tumor resection. For anatomical left hepatectomy the extra-hepatic artery, potal vein was isolated and ligated.The superior liver parenchyma was then dissected by using Harmonic scalpel. Moderate vessel was dissected by an ultrasonic dissector and sealed by the LigaSure(Valley lab). Finally the linear Endo-GIA was used to staple off the specimen from the hepatic vein. The specimen was removed by an extended umbilical/port incision or a small Pfannenstiel incision. Results There were 2 boys and 2 girls with an age range from 3 months to 4 years old. Operative time was between 100 minute and 340 minute with bleeding of 20~200 mL. No peri-operative complication was observed. The patients have been followed up for 3 months to 6 years and have remained asymptomatic since surgery. Conclusions These cases demonstrate the feasibility of laparoscopic hepatic resection, even for balking large tumors, employing standard principles of liver surgery and safety.
References:
1 Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008[J]. Ann Surg, 2009,(250(5):82 5— 830. 2高亚, 郑百俊, 段怡涛, 等. 腹腔镜肝左叶切除1例[D]. 首届全国小儿实验外科与临床新技术会议,辽宁,沈阳,2006,8:70 — 71. 3Yoon YS, Han HS, Choi YS, et al. Total laparoscopic left lateral sectionectomy performed in a child with benign liver mass[J]. J Pediatr Surg. 2006,41, 2 5— 28. 4Yeung CK, Chowdhary SK, Chan KW, et al. Atypical Laparoscopic Resection of a Liver Tumor in a 4-Year-Old Girl[J]. J Laparoendosc & Adv Surg Tech, 2006,16:32 5— 327. 5Rogers TN,Woodley H,Ramsden W,et al.Solitary liver cysts in children:not always so simple[J].J Pediatr Surg,2007,42, 33 3— 339. 6Dutta S, Nehra D, Woo R, et al. Laparoscopic resection of a benign liver tumor in a child[J]. J Pediatr Surg,2007,42:1141 — 1145. 7Goodman MD, Mak GC, Reynolds JP, et al. Laparoscopic Excision of a Ciliated Hepatic Foregut Cyst[J]. JSLS,2009,13:9 6— 100. 8Maazoun K, Mekki M, Chioukh FZ, et al. Laparoscopic treatment of hydatid cyst of the liver in children.A report on 3 4cases[J].J Pediatr Surg,2007,42:168 3— 1686. 9Tabrizian P,Midulla PS. Laparoscopic Excision of a Large Hepatic Cyst[J]. JSLS,2010, 14:27 2— 274. 10谢华伟,李龙,刘树立,等. 腹腔镜切除小儿肝脏肿物2例[J].中华小儿外科杂志,2010,31:474. 11Kim T, Kim DY, Cho MJ, et al. Use of laparoscopic surgical resection for pediatric malignant solid tumors: a case series[J]. Surg Endosc, 2011,25:148 4— 1488.