Table of Content

30 June 2026, Volume 13 Issue 2

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Original article

Efficacy evaluation of laparoscopic anatomical resection of the right posterior and dorsal segments of the hepatic lobe combined with right anterior region resection versus right hemihepatectomy in hepatocellular carcinoma

Luo Man, Hu Yaowei, Wang Zhihao, Wang Hongguang

2026, 13(2):  1-8. 

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Objective:To investigate the clinical efficacy of laparoscopic anatomical resection of the right posterior section combined with the dorsal segment of the right anterior section versus standard right hepatectomy for hepatocellular carcinoma (HCC).
Methods:A retrospective descriptive study was conducted. The clinical data of 34 patients with HCC admitted to the Cancer Hospital, Chinese Academy of Medical Sciences from January 2020 to January 2025 were collected. Based on the surgical procedures, the patients were divided into the combined resection group (anatomical resection of the right posterior section combined with the dorsal segment of the right anterior section, n=17) and the standard right hepatectomy group (right hepatectomy group, n=17). Intraoperative conditions, postoperative recovery indicators, and long-term follow-up prognosis were compared and analyzed between the two groups.
Results:Intraoperative findings demonstrated that all 34 patients successfully underwent laparoscopic anatomical hepatectomy without conversion to open surgery. Compared with the right hemihepatectomy group, the combined resection group exhibited longer operative duration and prolonged hepatic hilum occlusion time; however, both groups showed comparable intraoperative blood loss and transfusion volumes. The residual liver volume predicted by three-dimensional reconstruction was significantly larger in the combined resection group than in the right hemihepatectomy group. Postoperative evaluations revealed no in-hospital deaths or readmissions within 30 days among all 34 patients. Histopathological examinations confirmed hepatocellular carcinoma in all cases, with negative surgical margins. The combined resection group exhibited lower incidence of postoperative complications such as bile fistula and ascites, which resolved after irrigation drainage and peritoneal puncture drainage. The risk of postoperative liver failure was slightly lower in the combined resection group compared to the right hemihepatectomy group, though the difference was not statistically significant (P=0.403). Follow-up until March 1, 2026, showed that the combined resection group achieved superior overall survival and recurrence-free survival rates compared to the right hemihepatectomy group, although these differences were not statistically significant (P=0.34 and P=0.60).
Conclusions:Laparoscopic anatomical resection of the right posterior section combined with the dorsal segment of the right anterior section is safe and feasible for the treatment of HCC. Compared with standard right hepatectomy, this procedure can significantly preserve more future liver remnant and reduce the risk of postoperative liver failure, offering better perioperative benefits without compromising long-term oncological outcomes.

Correlation analysis between albumin-bilirubin-gamma-glutamyltransferase score and prognosis in patients with hepatocellular carcinoma

Chen Yan, Chen Li, Ni Jinlong, Zhu Mingfang, Li Hongbing

2026, 13(2):  9-17. 

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Objective:To investigate the accuracy of the albumin-bilirubin (ALBI) score combined with gamma-glutamyltransferase (GGT) in constructing an ALBI-GGT score for predicting postoperative prognosis in patients with hepatocellular carcinoma (HCC) undergoing curative liver resection.
Methods:Clinical data of 154 HCC patients who underwent curative liver resection from March 2018 to December 2023 were retrospectively collected. Univariate and multivariate Cox model analyses were performed to identify factors associated with patient prognosis. The ALBI-GGT score was constructed based on the regression coefficients of the ALBI score and GGT. The concordance index (C-index), Akaike information criterion (AIC), and Bayesian information criterion (BIC) were used to evaluate and compare the goodness-of-fit and complexity of the ALBI-GGT score. Kaplan-Meier survival curves and restricted cubic spline analysis were employed to examine the relationship between the ALBI-GGT score and patient survival status. Receiver operating characteristic (ROC) curve analysis with the area under the curve (AUC) was used to assess the ALBI-GGT score's ability in predicting the risk of postoperative death at 1, 3, and 5 years.
Results:The follow-up time for the 154 HCC patients ranged from 3.0 to 60.0 months, with a median survival time of 34.2 months. The 1-year, 3-year, and 5-year survival rates were 86.4%, 49.6%, and 41.8%, respectively. Univariate and multivariate Cox regression analyses identified both the ALBI score and GGT as independent risk factors for postoperative mortality in HCC patients (P<0.05). The likelihood ratio test indicated no significant interaction (HR=1.136, P=0.091), suggesting that the effects of the two factors are independent and additive.The ALBI-GGT score (1.643×ALBIs core+0.755×GGT) yielded C-index, AIC, and BIC values of 0.813, 703.636, and 706.102, respectively. The overall survival rate of patients with a high ALBI-GGT score was significantly lower than that of the low-score group (P<0.05). The restricted cubic spline model demonstrated a significant nonlinear relationship for the ALBI-GGT score (P<0.001). The score showed excellent predictive performance for postoperative mortality, with AUC of 0.820, 0.917, and 0.924 at 1, 3, and 5 years, respectively.
Conclusion:The ALBI-GGT score effectively integrates information related to liver function and tumor biology. It predicts the prognosis of HCC patients after curative liver resection more accurately than the ALBI score or GGT alone, and it is helpful for achieving more refined postoperative risk stratification and individualized management.

Nursing field

Based on the integration of the concept of enhanced recovery after surgery, the best evidence summary for the management of abdominal distension after liver cancer surgery

Yuan Rui, Kang Yongjiao, Liu Na, He Fengying

2026, 13(2):  18-25. 

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Objective:To systematically retrieve, evaluate, and summarize the best evidence for the management of abdominal distension after liver cancer surgery, providing an evidence-based basis for clinical practice.
Methods:From database inception to October 30, 2024, a computerized search was conducted in Chinese and English databases, including UpToDate, BMJ Best Practice, Cochrane Library, PubMed, CNKI, and Wanfang Data etc, to identify clinical guidelines, expert consensuses, systematic reviews, randomized controlled trials, and evidence summaries related to postoperative abdominal distension in liver cancer patients. The search timeframe spanned. Two researchers independently performed literature screening, quality assessment, and evidence extraction. The evidence was graded and synthesized according to the feasibility, appropriateness, meaningfulness, effectiveness principles.
Results:From 826 publications, a total of 13 articles were included, consisting of 7 guidelines, 1 expert consensus, 2 randomized controlled trials, and 3 studies of other types. Finally, 15 pieces of best evidence were summarized from aspects such as preoperative management (multidisciplinary team collaboration, intestinal preparation), postoperative management (analgesia, fluid management, dietary recovery, early ambulation), and auxiliary interventions (chewing gum, application of lactulose). This fills the gap in the research dimensions of domestic studies, covers the synergy of multiple links and adaptation to individual differences, and is more comprehensive and precise than similar studies. It clarifies the mechanism by which multi-dimensional interventions synergistically improve abdominal distension, reaching the advanced level in China.
Conclusions:The evidence system constructed in this study lays a foundation for standardized and individualized evidence-based nursing for postoperative abdominal distension in liver cancer, helping clinical practice to accurately meet patients' needs. However, the evidence system still needs to be improved, and further high-quality studies are required to continuously optimize the management practice of postoperative abdominal distension in liver cancer.