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Surgical Endoscopy

, Volume 22, Issue 1, pp 245–245 | Cite as

Laparoscopic right hemihepatectomy for hepatolithiasis

  • M. A. C. MachadoEmail author
  • F. F. Makdissi
  • R. C. T. Surjan
  • A. R. F. Teixeira
  • A. SepúlvedaJr
  • T. Bacchella
  • M. C. C. Machado
Video

Abstract

Background

Liver resection is the definitive treatment for unilateral hepatolithiasis [1]. Recently, laparoscopic major hepatectomias have become more common and are being performed in highly specialized centers [2, 3, 4]. However, few laparoscopic liver resections for hepatolithiasis have been reported. Chen et al. [5] reported two cases of laparoscopic left lobectomy for hepatolithiasis, but to our knowledge, right hepatectomy has never been reported to date. This video demonstrates technical aspects of a totally laparoscopic right hepatectomy in a patient with hepatolithiasis.

Methods

A 21-year-old woman with right-sided nonoriental primary intrahepatic stones [1] was referred for surgical treatment. The operation followed four distinct phases: liver mobilization, dissection of the right portal vein and right hepatic artery, extrahepatic dissection of the right hepatic vein, and parenchymal transection with harmonic shears and linear staplers for division of segment 5 and 8 branches of the middle hepatic vein. No Pringles’ maneuver was used. In contrast to liver resection for other indications, the right bile duct was enlarged and filled with stones. It was divided during parenchymal transection and left open. After removal of the surgical specimen, the biliary tree was flushed with saline until stone clearance, under radioscopic surveillance, was complete. The right hepatic duct then was closed with running suture.

Results

The operative time was 240 min, and the estimated blood loss was 120 ml, with no blood transfusion. The hospital stay was 5 days. At this writing, the patient is well and asymptomatic 7 months after the procedure.

Conclusion

Laparoscopic liver resection is safe and feasible for patients with hepatolithiasis and should be considered for those suffering from intrahepatic stones.

Keywords

Hepatolithiasis Laparoscopy Liver Technique 

Supplementary material

mov (36,649 KB)

References

  1. 1.
    Herman P, Perini MV, Machado MA, Bacchella T, Pugliese V, Saad WA, da Cunha JE, Machado MC, Rodrigues JG (2006) Liver resection as the definitive treatment for unilateral nonoriental primary intrahepatic lithiasis. Am J Surg 191:460–464PubMedCrossRefGoogle Scholar
  2. 2.
    Soubrane O, Cherqui D, Scatton O, Stenard F, Bernard D, Branchereau S, Martelli H, Gauthier F (2006) Laparoscopic left lateral sectionectomy in living donors: safety and reproducibility of the technique in a single center. Ann Surg 244:815–820PubMedCrossRefGoogle Scholar
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    O’Rourke N, Fielding G (2004) Laparoscopic right hepatectomy: surgical technique. J Gastrointest Surg 8:213–216PubMedCrossRefGoogle Scholar
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    Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B (2006) Laparoscopic liver resection. Br J Surg 93:67–72PubMedCrossRefGoogle Scholar
  5. 5.
    Chen P, Bie P, Liu J, Dong J (2004) Laparoscopic left hemihepatectomy for hepatolithiasis. Surg Endosc 18:717–718CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • M. A. C. Machado
    • 1
    Email author
  • F. F. Makdissi
    • 1
  • R. C. T. Surjan
    • 1
  • A. R. F. Teixeira
    • 1
  • A. SepúlvedaJr
    • 1
  • T. Bacchella
    • 1
  • M. C. C. Machado
    • 1
  1. 1.Department of GastroenterologyUniversity of São Paulo, BrazilSão PauloBrazil

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