ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1599403
This article is part of the Research TopicAdvances in Surgical Techniques and ML/DL-based Prognostic Biomarkers for Surgical and Adjuvant Therapies of Hepatobiliary and Pancreatic CancersView all 3 articles
Laparoscopic Counterclockwise Modular Mesohepatectomy for Hepatocellular Carcinoma: A Standardized Anatomical Approach (with video)
Provisionally accepted
- 1Department of Hepatobiliary Surgery, Mianyang Central Hospital,, Mianyang, China
- 2Department of Stomatology Mianyang Central Hospital, Mianyang, China
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Laparoscopic liver resection (LLR) is increasingly utilized for hepatocellular carcinoma (HCC).However, laparoscopic anatomical resection of Couinaud segments 4, 5, and 8 remains technically demanding due to complex vascular anatomy and a broad transection plane.This study retrospectively analyzed patients who underwent laparoscopic counterclockwise modular mesohepatectomy (LCMM) at our center. The LCMM approach standardizes the dissection sequence, optimizes vascular control, and utilizes Laennec's capsule theory to facilitate safe and precise anatomical liver resection. Perioperative outcomes, including operative time, intraoperative blood loss, and postoperative complications, were assessed.A total of 12 patients with centrally located HCC underwent LCMM. The mean operative time was 253.66 ± 52.47 minutes, and the mean intraoperative blood loss was 177.91 ± 112.76 mL.No conversions to open surgery or intraoperative transfusions were required. The mean postoperative hospital stay was 9.83 ± 4.26 days. Postoperative complications occurred in three patients (one bile leakage, one pulmonary infection, and one posthepatectomy liver failure). No perioperative mortality occurred. The mean disease-free survival (DFS) was 18.75 months.LCMM appears to be a technically effective and anatomically guided approach for managing centrally located HCC. It facilitates intraoperative control of key vascular structures and yields promising short-term oncological outcomes. Further prospective studies are warranted to confirm its long-term efficacy.
Keywords: Hepatocellular Carcinoma, Laparoscopic liver resection, Anatomical liver resection, mesohepatectomy, Laennec's capsule, Surgical technique
Received: 24 Mar 2025; Accepted: 03 Jun 2025.
Copyright: © 2025 Chen, He, Wang, Kuang, Jiang, Luo and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xi Chen, Department of Hepatobiliary Surgery, Mianyang Central Hospital,, Mianyang, China
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