Minimally invasive surgical treatment of primary liver cancer with portal hypertension

doi:10.3877/cma.j.issn.1674-6899.2024.05.010

Abstract

Abstract:

Objective

To review and summarize the laparoscopic surgical treatment for patients with primary liver cancer complicated by portal hypertension at our center， and to discuss the surgical treatment principles for these patients.

Methods

A patient with hepatitis B-related liver cirrhosis， recurrent upper gastrointestinal bleeding， and recent clinical diagnosis of primary liver cancer with portal vein hypertension，admitted to the Department of Hepatobiliary and Liver Transplant Surgery at Nanjing Drum tower Hospital in May 2024， was evaluated through liver function and reserve assessment， gastrointestinal endoscopy， and tumor staging. Based on these evaluations， a surgical treatment plan was formulated.

Results

The patient successfully underwent laparoscopic liver resection combined with total splenectomy and laparoscopic periscardia vascular disconnection. The procedure had minimal blood loss， and there were no postoperative complications such as infection， bleeding， bile leakage， or portal vein thrombosis. Recovery was smooth，and postoperative pathological examination confirmed combined hepatocellular carcinoma and cholangiocarcinoma.

Conclusion For patients with primary liver cancer complicated by portal hypertension，a comprehensive preoperative assessment allows for surgical treatment of both the tumor and complications of portal hypertension could benefit the patient.

Key words: Liver cancer, Portal hypertension, Laparoscopic hepatosplenectomy, Laparoscopic periscardia vascular disconnection

Fei Wang, Zheng Chen, Decai Yu, Yajuan Cao. Minimally invasive surgical treatment of primary liver cancer with portal hypertension[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2024, 17(05): 306-310.

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References 16

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项目	第1天	第2天	第5天	第8天	第10天	第65天
白细胞（×10⁹）	8.7	13.7	6.4	7.0	6.4	6.6
血红蛋白（g/L）	82	91	87	89	91	99
血小板（×10⁹）	93	135	231	416	436	299
谷丙转氨酶（U/L）	176.2	-	92.8	34.2	38	47.4
谷草转氨酶（U/L）	254.4	-	34.6	23.1	41	51.8
总胆红素（μmol/L）	20.4	-	18.5	9.5	10.4	12.5

项目	第1天	第2天	第5天	第8天	第10天	第65天
白细胞（×10⁹）	8.7	13.7	6.4	7.0	6.4	6.6
血红蛋白（g/L）	82	91	87	89	91	99
血小板（×10⁹）	93	135	231	416	436	299
谷丙转氨酶（U/L）	176.2	-	92.8	34.2	38	47.4
谷草转氨酶（U/L）	254.4	-	34.6	23.1	41	51.8
总胆红素（μmol/L）	20.4	-	18.5	9.5	10.4	12.5

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