Langenbeck's Archives of Surgery

, Volume 392, Issue 4, pp 485–488 | Cite as

Liver resection without hilus preparation and with selective intrahepatic hilus stapling for benign tumors and liver metastasis

  • Ingmar KönigsrainerEmail author
  • Wolfgang Steurer
  • Maria Witte
  • Alfred Königsrainer
How To Do IT



Nowadays, liver resection is a routine operative procedure in surgical centers, and strategies must be aimed at avoiding additional risk factors. Extrahepatic isolation of portal vein, hepatic artery and hepatic duct, as well as lymphadenectomy of the liver hilum are generally accepted steps of liver resection, even for metastatic and benign indications. Our primary aim was to analyze the feasibility, blood loss, blood transfusion requirements, incidence of complications, and outcome using the approach for intrahepatic devascularization leaving the extrahepatic hilus untouched.

Materials and methods

Thirty-eight consecutive patients with resection for metastases and benign liver tumors were selected. After hilar examination, the extrahepatic structures remain intact, and during parenchyma dissection, the whole right or left or the appropriate bi-segmental pedicle is isolated intrahepatically and then transected using a stapler device.


The used technique was feasible in all cases, and no intra- or postoperative surgical complications were observed. To date, no tumor recurrence was found in the hilum during the follow-up period.


The intrahepatic pedicle stapling technique appears to be feasible and safe in liver resection. Hilar dissection can, thus, be avoided in liver metastasis and benign liver tumors.


Liver resection Liver metastasis Intrahepatic stapling No hilus preparation 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Ingmar Königsrainer
    • 1
    Email author
  • Wolfgang Steurer
    • 1
  • Maria Witte
    • 1
  • Alfred Königsrainer
    • 1
  1. 1.Department of General, Visceral and Transplant SurgeryTübingen University HospitalTübingenGermany

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