Laparoscopic left hemihepatectomy combined with right lateral hepatic lobectomy in pigs: surgical approach and comparative study of the inflammatory response versus open surgery

Document Type: Original Article

Authors

1 Beijing University of Agriculture

2 Northeast Agricultural University

10.30466/vrf.2019.105865.2518

Abstract

This study describes a left hemihepatectomy combined with a right lateral hepatic lobectomy and compares the inflammatory response associated with a laparoscopic hepatectomy (LH group, n=7) with that associated with a conventional open hepatectomy (OH group, n=7). Blood was collected before surgery, as well as 1, 3, and 7 days after surgery, to determine the white blood cell (WBC) count and the levels of serum cortisol (COR), interleukin-6 (IL-6), and C-reactive protein (CRP). The left hemihepatectomy combined with a right lateral hepatic lobectomy was successfully completed in miniature pigs. The average operative time was 139.00±9.07 min, which was longer than that in the OH group (121.67±3.02 min; 0.01< p <0.05). The length of the surgical incision associated with the OH group was 17.93±1.09 cm, which was significantly longer than that associated with the LH group (5.10±0.17 cm; p <0.01). The estimated mean blood loss in the LH group was 136.43±63.24 ml, which was significantly lower than that in the OH group, and no serious complications (e.g., massive bleeding, bile leakage, and air embolism) were reported. The levels of CRP, COR, and IL-6 increased significantly in the OH group (p <0.01) and then slowly returned to their preoperative levels. These findings indicate that a 4-trocar method for laparoscopic left hemihepatectomy combined with right lateral hepatic lobectomy is safe and feasible and that the inflammatory response for those receiving LH is lower than that for those receiving OH. This porcine model can be used as a research analog for liver disease and liver regeneration.

Keywords



Articles in Press, Accepted Manuscript
Available Online from 29 September 2020
  • Receive Date: 06 April 2019
  • Revise Date: 20 July 2019
  • Accept Date: 06 August 2019