Up-to-down open and laparoscopic liver hanging maneuver: an overview
| Autor: | François Cauchy, Wael Rebai, Olivier Soubrane, Safi Dokmak, Béatrice Aussilhou, Jacques Belghiti |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Hepatic Veins 030230 surgery Inferior vena cava 03 medical and health sciences 0302 clinical medicine medicine Hepatectomy Humans cardiovascular diseases Vein Fibrous capsule of Glisson business.industry Liver Neoplasms Surgery Cardiac surgery Dissection medicine.anatomical_structure Liver medicine.vein Cardiothoracic surgery 030220 oncology & carcinogenesis cardiovascular system Laparoscopy business Abdominal surgery |
| Zdroj: | Langenbeck's Archives of Surgery. 406:19-24 |
| ISSN: | 1435-2451 1435-2443 |
| Popis: | The liver hanging maneuver (LHM) was described by Belghiti et al. to facilitate liver resection and is done classically by creating a space between the caudate lobe and the inferior vena cava starting on the edge of caudate lobe and extending cranially, in a para-caval fashion, towards the space between the right and middle hepatic veins. LHM facilitates liver transection, guides anatomical resections, decreases blood loss, facilitates harvesting of the liver graft in live donors, and also has oncological advantages. We describe a new approach named “up-to-down” to perform LHM in open and laparoscopic liver resections. This approach was mainly used in obese patients, in laparoscopic liver resections and in cases of failure of the classic approach. The advantages/disadvantages, complications, and different modalities of LHM are also summarized. The peritoneal layer between the liver capsule and the infrahepatic vena cava is opened, and a short blind dissection is initiated on the right anterolateral aspect of the inferior vena cava to the left of the hepatic vein of segment VI. The suprahepatic vena cava is exposed, and the space between the right and middle hepatic veins and the vena cava is created by gentle dissection. A 16-Fr nasogastric tube is positioned in the space between the right and middle hepatic vein, pointing inferiorly, and pushed downwards, in a para-caval manner caudally until it is seen inferiorly. The results of this approach are given. LHM facilitates liver resection, and many variations have been described worldwide in open and laparoscopic liver surgery. The up-to-down approach should be part of the surgical armamentarium in order to offer a safer way to achieve LHM in some patients. |
| Databáze: | OpenAIRE |
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