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Middle and left hepatic vein trunk control during laparoscopic liver resection (with video)

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Abstract

Background

While inflow control can be easily applied by Pringle maneuver, outflow control of the left liver has not been formally described. We report here a safe and reproductible technique of middle and left hepatic veinous trunk control (MLHVC) before parenchymal transection during laparoscopic left hepatectomy.

Methods

A retrospective review of laparoscopic liver resection was conducted from January 2013 to March 2018 from our prospective database. All cases of laparoscopic left hepatectomy (LLH) were included, and intra- and postoperative outcomes data collected. We collected cases where the middle and left hepatic vein trunk control has been attempted and clamping used, and we analyzed outcomes associated with this maneuver.

Results

MLHVC was attempted in 28 cases (77.8) of the 36 LLH identify in a monocentric study. It was technically not feasible only in 3 cases (8.3%) and clamping applied in 15 cases (41.7%). No significant intraoperative unexpected event occurred.

Conclusion

We present here a technique for left liver outflow control that can be safely added to the armamentarium of laparoscopic liver surgery.

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Abbreviations

MLHVC:

Middle and left hepatic vein trunk control

LLHH:

Laparoscopic left hepatectomy

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Authors and Affiliations

  1. Department of Hepato-Biliary Surgery and Transplantation, Centre Hépato-biliaire, Hopital Paul-Brousse, Université Paris-Sud, Villejuif, France

    Ugo Marchese, Marc-Antoine Allard, Romaric Tobome, Julio Nunez, Maximilliano Gelli, Gabriella Pittau, Oriana Ciaccio, Antonio Sa Cunha & Daniel Cherqui

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  1. Ugo Marchese
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  2. Marc-Antoine Allard
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  3. Romaric Tobome
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  4. Julio Nunez
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  5. Maximilliano Gelli
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  6. Gabriella Pittau
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  7. Oriana Ciaccio
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  8. Antonio Sa Cunha
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  9. Daniel Cherqui
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Corresponding author

Correspondence to Daniel Cherqui.

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Disclosures

Ugo Marchese, Marc-Antoine Allard, Romaric Tobome, Julio Nunez, Maximilliano Gelli, Gabriella Pittau, Oriana Ciaccio, Antonio Sa Cunha and Daniel Cherqui have no conflicts of interest or financial ties to disclose.

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Marchese, U., Allard, MA., Tobome, R. et al. Middle and left hepatic vein trunk control during laparoscopic liver resection (with video). Surg Endosc 35, 1476–1481 (2021). https://doi.org/10.1007/s00464-020-08116-z

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  • DOI: https://doi.org/10.1007/s00464-020-08116-z

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