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

• Published in: Veterinary research forum 2021, Vol.12 (1), p.1-6
• Main Authors: Zhang, Hua, Tong, Jin-Jin, Zhang, Zhao-Nan, Wang, Hong-Bin, Zhang, Yong-Hong
• Format: Article
• Language: English
• Subjects: Abdomen; Anesthesia; Animal models; Blood; C-reactive protein; Cortisol; Cytokines; Embolism; Hepatectomy; Hogs; Inflammation; Interleukin 6; Laparoscopy; Ligaments; Liver; Liver diseases; Omentum; Original; Physiology; Surgery; Veins & arteries
• ISSN: 2008-8140; 2322-3618
• DOI: 10.30466/vrf.2019.105865.2518

This study describes a left hemihepatectomy combined with a right lateral hepatic lobectomy. It compares the inflammatory response associated with laparoscopic hepatectomy (LH group, n = 7) with conventional open hepatectomy (OH group, n = 7). Blood was collected before surgery as well as 1, 2, 3, 5, and 7 days after surgery to determine the white blood cell count and 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 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). The length of surgical incision associated with the OH group was 17.93 ± 1.09 cm, significantly longer than that related to the LH group (5.10 ± 0.17 cm). 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. No severe complications (e.g., massive bleeding, bile leakage, and air embolism) were reported. The CRP levels, COR, and IL-6, increased significantly in the OH group and then slowly returned to their preoperative levels. A postoperative laparoscopic exploration revealed that the incised portion of the liver adhered to the omentum, but no additional abnormalities were observed. These findings indicate that a 4-trocar method for laparoscopic left hemihepatectomy combined with a right lateral hepatic lobectomy is safe and feasible. The inflammatory response for those receiving LH are lower than that for those receiving OH. This porcine model can be used as a research analog for liver disease and regeneration.