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Feasibility of hanging maneuvers in orthotopic liver transplantation with inferior vena cava preservation and in liver surgery

  • Giuseppe Maria Ettorre
  • Giovanni Vennarecci
  • Arianna Boschetto
  • Richard Douard
  • Eugenio Santoro
Basic knowledge of interest

Abstract

Background/Purpose

The aim of this work was to study the feasibility and complication rates of liver hanging maneuvers: the Belghiti liver hanging maneuver (BLHM) in liver resection and the modified liver hanging maneuver (MLHM) in orthotopic liver transplantation (OLT) with inferior vena cava (IVC) preservation.

Methods

From January 2001 to August 2003, BLHM was planned in 26 consecutive right hepatectomies and MLHM in 28 consecutive OLTs with IVC preservation.

Results

BLHM was performed in 24/26 patients (92%). In the 2 remaining patients, chronic biliary infection (n = 1) and intraparenchymal hemorrhagic hepatocellular carcinoma (n = 1) did not allow BLHM to be achieved. Bleeding during the BLHM procedure occurred in 1 patient (4%), with no need for interruption. MLHM was performed in all 28 patients, and in none of them was bleeding observed during the maneuver.

Conclusions

BLHM and MLHM are important technical refinements with several advantages. Feasibility rates were 92% and 100%, respectively. Bleeding risk remained low (4%) for BLHM and was 0% for MLHM. The rate of BLHM failure suggests that the feasibility rate may be higher in normal liver parenchyma.

Key words

Orthotopic liver transplantation Inferior vena cava preservation Belghiti liver hanging maneuver Modified liver hanging maneuver 

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Copyright information

© Springer-Verlag Tokyo 2004

Authors and Affiliations

  • Giuseppe Maria Ettorre
    • 1
  • Giovanni Vennarecci
    • 1
  • Arianna Boschetto
    • 1
  • Richard Douard
    • 2
  • Eugenio Santoro
    • 1
  1. 1.Department of Digestive Surgery and Liver TransplantationRegina Elena Cancer InstituteRomeItaly
  2. 2.Institut d’Anatomie de Paris, Faculty of Medicine Necker-Enfants-MaladesParis V UniversityParisFrance

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