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Basic Techniques for Hepatic Resection by the Glissonean Approach

  • Jixiong Hu
  • Jiangsheng Huang
  • Xianling Liu
  • Zhongkun Zuo
Chapter

Abstract

Liver resection for the treatment of hepatocellular carcinoma has progressed greatly over the last 20 years. Notable advancements include increased utilization of parenchymal-preserving resections, better patient selection, use of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), use of 3D virtual resection and reconstruction technology, and improvements in perioperative management [1]. Because of these changes, the postoperative morbidity and mortality have significantly decreased [2, 3]. Even if like this, intraoperative severe hemorrhage still is a potentially lethal problem, especially in patients with HCC associated with cirrhosis [4, 5]. Moreover, perioperative blood transfusion has been found to negatively influence long-term overall and disease-free survival [6, 7]. Therefore, minimizing blood loss while performing oncologically sound hepatectomy should be the primary goals of hepatic surgeons. During liver resection, blood loss occurs due to bleeding both from the vascular inflow system and from the vascular outflow system. It is similarly crucial to occlude the inflow and outflow systems to minimize bleeding during hepatic resection.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Jixiong Hu
    • 1
  • Jiangsheng Huang
    • 2
  • Xianling Liu
    • 3
  • Zhongkun Zuo
    • 2
  1. 1.Department of Hepatobiliary Surgery and Hunan Provincial Key Laboratory of Hepatobiliary Disease ResearchThe Second Xiangya Hospital, Central South UniversityChangshaPR China
  2. 2.Department of Minimally Invasive SurgeryThe Second Xiangya Hospital, Central South UniversityChangshaPR China
  3. 3.Department of OncologyThe Second Xiangya Hospital, Central South UniversityChangshaPR China

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