Abstract
Background
Hepatic trisectionectomy is a challenge for surgeons. We describe a technique by combination of the Glisson pedicle method and anterior approach to perform hepatic trisectionectomy.
Methods
In this technique, the Glisson pedicles are isolated above the hilar plate without hilar dissection. After dividing these pedicles, the hepatic hilum can be lowered more easily. With the hepatic hilum brought down, the following step of hepatic parenchyma transection using the anterior approach can be performed safely, avoiding accidental injury to the vessels and hepatic duct in the hilar plate.
Conclusions
This technique provides a safe, easy way to perform hepatic trisectionectomy without warm ischemia injury to the remnant liver.
References
Reynaud BH, Coucoravas GO, Giuly JA (1991) Basis to improve several hepatectomy techniques involving the surgical anatomy of incisura dextra of Gans. Surg Gynecol Obstet 172:490–492
Machado MA, Herman P, Machado MC (2004) Anatomical resection of left liver segments. Arch Surg 139:1346–1349
Machado MA, Herman P, Machado MC (2003) A standardized technique for right segmental liver resections. Arch Surg 138:918–920
Machado MA, Herman P, Makdissi FF et al (2005) Anatomic left hepatic trisegmentectomy. Am J Surg 190:114–117
Machado MA, Makdissi FF, Surjan RC et al (2009) Intrahepatic Glissonian approach for laparoscopic right trisectionectomy. J Laparoendosc Adv Surg Tech A 19:777–778 discussion 778–779
Wu TJ, Wang F, Lin YS et al (2010) Right hepatectomy by the anterior method with liver hanging versus conventional approach for large hepatocellular carcinomas. Br J Surg 97:1070–1078
Acknowledgments
The authors are grateful to Xue-Bin Wang for preparing the drawings.
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Xie, KL., Zeng, Y. & Wu, H. Hepatic Trisectionectomy for Hepatocellular Carcinoma Using the Glisson Pedicle Method Combined with Anterior Approach. World J Surg 38, 2358–2362 (2014). https://doi.org/10.1007/s00268-014-2579-y
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DOI: https://doi.org/10.1007/s00268-014-2579-y