Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection

Wanli Wang; Yinchuan Xiang; Bin Guo; Kai He; Hansheng Huang; Yu Cao; Liangjie Wang; Zhiyong Zhang; Youjun Luo

doi:10.3791/69488

JoVE Journal
Medicine

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JoVE Journal Medicine

Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection

腹腔镜解剖S7+S8d切除，保留右侧肝静脉及S6右肝静脉切断

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06:00 min

December 30, 2025

DOI: 10.3791/69488-v

Wanli Wang*¹, Yinchuan Xiang*^1,2, Bin Guo¹, Kai He¹, Hansheng Huang¹, Yu Cao¹, Liangjie Wang¹, Zhiyong Zhang¹, Youjun Luo¹

¹Department of Hepatobiliary, Pancreatic, Splenic, and Vascular Surgery,Bazhong Central Hospital, ²Hepatobiliary Surgery Department,The Affiliated Hospital of Southwest Medical University

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我们提出了一种腹腔镜技术，用于右肝静脉截断，用于解剖学S7+S8d切除，保留下右肝静脉和S6节段。该方法依赖细致的解剖标志，无需术中超声，为右肝背侧肿瘤提供了精准且保留实质的选择，尤其是在导航资源有限的环境中。

本研究旨在利用解剖标志而非先进技术，在资源有限的环境中开发复杂肝肿瘤的可及外科手术技术。由于能见度差、边界不明以及特殊的解剖结构要求，挑战在于在没有导航的情况下进行精确切除。首先，在腹部通路后，使用单极能量装置分割圆韧带和镰状韧带。

切除第二肺门以暴露腔窝，实现右侧肝静脉的完整可见。在第一个肝门处使用14号法式导管，预置Pringle动作止血带。切断右三角韧带，将右肝从背侧下侧完全活动，通过小心分离乳晕组织，露出下腔静脉。

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本月JoVE 第226期微创解剖肝切除（MIALR） S7+S8d切除肝细胞癌（HCC）右下肝静脉（IRHV） S6保存