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Modified liver hanging maneuver with extraparenchymal isolation of the middle hepatic vein in left hepatectomy

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Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background/purpose

The liver hanging maneuver has been employed mostly for right hepatectomy. After the space between the inferior vena cava and the liver parenchyma is bluntly dissected, a tape is passed through the space, with the upper end of the tape between the right hepatic vein and middle hepatic vein (MHV). We devised a modified maneuver with tape repositioning between the MHV and left hepatic vein (LHV) after extraparenchymal isolation of the MHV, in left hepatectomy with the caudate lobe and without the MHV.

Methods

The ligamentum venosum is divided. Traction of the cranial stump of the ligament in the cranial and left direction shows an avascular plane between the LHV and MHV, and enables the taping of each MHV and LHV. Finally, the upper end of the hanging tape is repositioned.

Results

This maneuver was successfully performed in three patients.

Conclusions

The present maneuver is feasible and useful in left hepatectomy.

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Authors and Affiliations

  1. Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Masanori Sugiyama, Yutaka Suzuki, Nobutsugu Abe, Tadahiko Masaki, Toshiyuki Mori & Yutaka Atomi

Authors
  1. Masanori Sugiyama
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  2. Yutaka Suzuki
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  3. Nobutsugu Abe
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  4. Tadahiko Masaki
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  5. Toshiyuki Mori
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  6. Yutaka Atomi
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Corresponding author

Correspondence to Masanori Sugiyama.

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Cite this article

Sugiyama, M., Suzuki, Y., Abe, N. et al. Modified liver hanging maneuver with extraparenchymal isolation of the middle hepatic vein in left hepatectomy. J Hepatobiliary Pancreat Surg 16, 156–159 (2009). https://doi.org/10.1007/s00534-008-0024-z

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  • DOI: https://doi.org/10.1007/s00534-008-0024-z

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