Document Detail


Right hepatectomy using the liver double-hanging maneuver through the retrohepatic avascular tunnel on the right of the inferior vena cava.
MedLine Citation:
PMID:  19081028     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The key to Belghiti's liver-hanging maneuver is to develop a retrohepatic tunnel. This procedure requires a blind dissection of the plane anterior to the inferior vena cava (IVC), with the inherent risks of damaging the short hepatic veins and consequential bleeding. The aim of this article is to describe a liver double-hanging maneuver with the advantage of being technically simple and safe. METHODS: The operator uses his or her right index finger to dissect the space from below upward between the hepatic parenchyma and the anterior and superior edge of the right adrenal gland, which is situated just on the right side of the IVC. The operator then uses his left index finger to dissect the retrohepatic space from above downward on the right side of suprahepatic IVC, which is lateral to where the right hepatic vein joins the IVC. The retrohepatic tunnel is built when the 2 fingers touch each other. A kidney pedicle forceps is used to place 2 tapes around the liver for suspension. RESULTS: In all, 65 patients underwent right hepatectomy using this maneuver. The study included 62 patients with hepatocellular carcinoma (tumor size: mean +/- SD, 10 +/- 3.7 cm), and 3 patients had hepatic cavernous hemangioma, with a maximum diameter of 12.6 cm, 14.4 cm, and 22.6 cm, respectively. No major bleeding was encountered during the creation of the retrohepatic tunnel, with a success rate of 100%. CONCLUSION: To develop the retrohepatic tunnel in the space on the right of the IVC is absolutely bloodless, and it is technically easy and safe.
Authors:
Xiao Ping Chen; Wan Guang Zhang; Wan Yee Lau; Fa Zu Qiu
Related Documents :
17565638 - Predicting pleural effusion and ascites following extended hepatectomy in the non-cirrh...
20961368 - Utility of preoperative imaging in evaluating colorectal liver metastases declines over...
3756438 - Non-operative management of penetrating liver injuries: a prospective study.
21160728 - Advances in endoscopic retrograde cholangiopancreatography cannulation.
12019008 - Occlusal relationship in patients with bilateral cleft lip and palate during the mixed ...
10561098 - Return hospital visits and hospital readmissions after ambulatory surgery.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-09-26
Journal Detail:
Title:  Surgery     Volume:  144     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  830-3     Citation Subset:  AIM; IM    
Affiliation:
Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. chenxp@medmail.com.cn
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Carcinoma, Hepatocellular / pathology,  surgery*
Cohort Studies
Female
Hemangioma, Cavernous / pathology,  surgery*
Hepatectomy / methods*
Humans
Liver Neoplasms / pathology,  surgery*
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Vena Cava, Inferior

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Natural history of common iliac arteries after aorto-aortic graft insertion during elective open abd...
Next Document:  Response: When does grasping escape Weber's law?