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Annals of Surgical Oncology

, Volume 24, Issue 8, pp 2353–2354 | Cite as

Laparoscopic Parenchymal-Sparing Liver Resections Using the Intrahepatic Glissonian Approach

  • Marcel Autran C. MachadoEmail author
  • R. Surjan
  • T. Basseres
  • F. Makdissi
Hepatobiliary Tumors

Abstract

Background

One of the main criticisms of laparoscopic liver resection is that it is difficult, or not possible, to perform liver-sparing resections. Our aim was to present short videos where the intrahepatic Glissonian approach was used to perform anatomical liver segmental resections, instead of a larger operation, to avoid unnecessary sacrifice of the liver parenchyma.

Methods

We selected six types of anatomical liver resections to exemplify the use of the intrahepatic Glissonian approach to perform segment-oriented liver resections. These types of hepatectomies were used as an alternative to right or left hepatectomy, or as an alternative to extended liver resections.

Results

The intrahepatic Glissonian approach was feasible in all cases. The use of anatomical landmarks previously described was essential to reach and control the Glissonian pedicles. Among the liver-sparing resections, we were able to perform right anterior (S5 + S8) and posterior (S6 + S7) sectionectomies, resection of segments 2, 3, and 4, and mesohepatectomy (S4 + S5 + S8). No patient presented postoperative liver failure.

Conclusions

Laparoscopic liver-sparing resections are feasible and may be a good alternative to hemihepatectomies or extended liver resections. The use of the intrahepatic Glissonian approach can be useful.

Keywords

Liver Resection Laparoscopic Liver Resection Postoperative Liver Failure Left Hepatectomy Anatomical Liver 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

10434_2017_5886_MOESM1_ESM.mp4 (129.4 mb)
This video shows six situations where the intrahepatic Glissonian approach was used to perform laparoscopic parenchymal-sparing liver resections (anatomical hepatectomies) instead of a larger operation such as hemihepatectomy or trisectionectomy. Supplementary material 1 (MP4 132509 kb)

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Marcel Autran C. Machado
    • 1
    Email author
  • R. Surjan
    • 1
  • T. Basseres
    • 1
  • F. Makdissi
    • 1
  1. 1.Department of SurgeryUniversity of São PauloSão PauloBrazil

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