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자료유형
학술저널
저자정보
Wontae Cho (Hallym University Medical Center, Dongtan Sacred Heart Hospital) Choon Hyuck David Kwon (Sungkyunkwan University School of Medicine) Jin Yong Choi (Soonchunhyang University Seoul Hospital) Seung Hwan Lee (Kyung Hee University Medical Center) Jong Man Kim (Sungkyunkwan University School of Medicine) Gyu Seong Choi (Sungkyunkwan University School of Medicine) Jae-Won Joh (Sungkyunkwan University School of Medicine) Sung Joo Kim (Sungkyunkwan University School of Medicine) Gaab Soo Kim (Sungkyunkwan University School of Medicine) Kwang Chul Koh (Sungkyunkwan University School of Medicine)
저널정보
대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.96 No.1
발행연도
2019.1
수록면
14 - 18 (5page)

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Purpose: Laparoscopic major liver resection (major LLR) remains a challenging procedure because of the technical difficulty. Several significant technical innovations have been applied in our center since 2012. They include routine application of bipolar electrocautery, initiation of temporary increase of intra-abdominal pressure during bleeding events from veins to balance the central venous pressure, and use of temporary inflow control of the Glissonean pedicle. This study evaluated the impact of these technique modifications in patients with major LLR.
Methods: Between January 2004 and February 2015, a total of 606 patients underwent LLR at Samsung Medical Center in Seoul, Korea. Major LLR was employed in 233 cases. All major LLR procedures were anatomical resections performed with a totally laparoscopic approach. We compared surgical parameters of right hepatectomy (RH), left hepatectomy (LH), and right posterior sectionectomy (RPS) before and after 2012.
Results: Open conversion rates of RH and LH and estimated blood loss in RPS significantly decreased after 2012. The postoperative complication rate of major LLR was 12.7% and was similar before and after 2012. Bile leakage was the most common complication (3.2%).
Conclusion: The modifications of surgical techniques resulted in good outcomes for laparoscopic major LLR. We recommend routine application of these techniques to improve outcomes, especially in patients requiring major liver resection.

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INTRODUCTION
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UCI(KEPA) : I410-ECN-0101-2019-514-000442253