关键词: 胃癌； 肝粘贴悬吊法； W型悬吊肝左叶； 前腹壁肝脏V型悬吊法； 腹腔镜根治术

Abstract: Objective To explore the effects of liver paste suspension,W-type suspension of left lobe of liver and V-type suspension of anterior abdominal wall of liver in laparoscopic radical gastrectomy.Methods The clinical data of 79 patients with gastric cancer who underwent laparoscopic radical gastrectomy in our hospital from October 2018 to October 2022 were retrospectively analyzed.According to the different treatment methods in the data,79 patients were divided into group A (26 cases),group B (26 cases),and group C (27 cases).In group A,the liver paste suspension method was used,and in group B,the left lobe suspension method was used,and in group C,the front abdominal wall liver V suspension method was used.All three groups were followed up to 6 months after operation.The general data,operation index,complication rate and liver function changes before and 7 days after operation were compared among three groups.Results The time of liver suspension and operation in group B[(16.23±2.52) min,(318.48±30.62)min] was longer compared with group A[(2.64±0.61）min,（233.64±20.67）min] and group C[(12.43±1.56）min,(270.81±25.77）min],and the time of liver suspension and operation in group C was longer than that in group A,and the amount of blood loss and blood transfusion in group B[(224.51±20.27)ml,5 cases] and group C[(223.54±21.87)ml,7 cases] were lower than those in group A[(324.54±30.51)ml,15 cases](P<0.05).The levels of serum glutamic-pyruvate transaminase (ALT),aspartate transaminase (AST) and Albumin (ALB) in group B[(27.52±3.62) U/L,(25.75±3.95) U/L,and (31.65±3.18) g/L] and group C[(26.54±3.73） U/L,(26.34±3.82） U/L and (32.06±3.09） g/L] were higher than those before operation 7 days after operation,and the levels of serum ALT,AST and ALB in group B and group C were higher than those in group A(P<0.05).The incidence of postoperative liver laceration and bleeding in group A (11.54%,7.69%) was higher,and the incidence of intraoperative peritoneal bleeding in group B (11.54%) was higher,but the difference was no significant among three groups(P>0.05).Conclusion The liver paste suspension method is simple and time-saving,but it is not suitable for left liver hypertrophy,and postoperative degumming may cause liver surface tear and bleeding.W-type suspension has good effect and takes a little longer and is suitable for patients with obesity and hypertrophy of left lobe of liver.The suspension effect of V-shaped gauze is moderate and the time consumption is moderate.

Key words: gastric cancer; liver paste suspension method; the left lobe of liver was suspended in W shape; Type V suspension method of the anterior abdominal wall liver; laparoscopic radical surgery