Abstract
Situs inversus totalis is a rare congenital anomaly in which the major abdominal organs are located as a mirror image of their normal positions. This poses much difficulty for surgeons. We describe how we performed the liver-hanging maneuver (LHM) for hepatocellular carcinoma (HCC) in a 59-year-old man with situs inversus totalis, to resolve the difficulty of the mirror-image location of his liver. The HCC was located in the right lateral sector. Although segmentectomy of segment 7 would normally be considered minimal for a curative treatment of HCC, this was relatively complicated in this patient. Thus, we performed an extended right lateral sectionectomy using the LHM to achieve a simple transection. The hepatic hilum was dissected using the Glissonean pedicle transection method. The operation time and intraoperative blood loss were 6 h 45 min and 471 ml, respectively. No blood product transfusion was required. The LHM and the hilar Glissonean pedicle approach proved effective for resolving the difficulties of performing surgery in a mirror image for HCC in a patient with situs inversus totalis.
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Abbreviations
- HCC:
-
Hepatocellular carcinoma
- LHM:
-
Liver-hanging maneuver
- IVC:
-
Inferior vena cava
- HBs-Ag:
-
Hepatitis B antigen
- HCV-Ab:
-
Hepatitis C antibody
- AFP:
-
α-Fetoprotein
- AFP-L3:
-
Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein
- PIVKA-II:
-
Protein induced by vitamin K absence or antagonists-II
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Kazuto Harada and his co-authors have no conflict of interest.
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Harada, K., Masuda, T., Beppu, T. et al. Hepatic resection using a liver-hanging maneuver and Glissonean pedicle transection for hepatocellular carcinoma in a patient with situs inversus totalis: report of a case. Surg Today 42, 801–804 (2012). https://doi.org/10.1007/s00595-012-0156-2
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DOI: https://doi.org/10.1007/s00595-012-0156-2