Development and key points of laparoscopic portal territory anatomical liver resection
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Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510000, China

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R735.7

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    Abstract:

    The development of classical anatomical liver resection has been a topic of considerable debate, particularly regarding its oncological efficacy in treating hepatocellular carcinoma. With continuous advancements in surgical techniques and iterative improvements in minimally invasive surgical equipment, laparoscopic portal territory anatomical resection (LPTAR) has gradually been adopted in clinical practice. Unlike classical anatomical liver resection, which approximates liver segmentectomy based on Couinaud's segmentation, LPTAR integrates technologies such as preoperative 3D visualization and intraoperative indocyanine green fluorescence navigation to target the true portal venous territory. Its core principle lies in achieving "precise liver segmentectomy" of the tumor-bearing portal venous territory. Currently, LPTAR is undergoing rapid development but faces several technical challenges, including the precise identification and control of hepatic pedicles, effective staining of difficult liver segments, and management of anatomical variations. Establishing standardized and streamlined technical protocols is crucial to addressing these issues, as it will improve surgical completeness and safety while enhancing oncological outcomes. Precision liver resection has long been a pursuit of surgeons, and laparoscopic liver resection, led by LPTAR, is poised to make a lasting impact in the field of precision hepatic surgery.

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WANG Anzhi, ZHANG Fan, DU Jingyang, ZHOU Rui, CHEN Jie, CAO Jun. Development and key points of laparoscopic portal territory anatomical liver resection[J]. Chin J Gen Surg,2025,34(1):62-69.
DOI:10.7659/j. issn.1005-6947.240568

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History
  • Received:November 07,2024
  • Revised:January 10,2025
  • Adopted:
  • Online: March 14,2025
  • Published: