Liver hanging maneuver for right hemiliver in situ donation ‐ anatomical condiderations

• Published in: HPB (Oxford, England) England), 2006-02, Vol.8 (1), p.35-37
• Main Authors: Trotovšek, B., Gadžijev, E.M., Ravnik, D., Hribernik, M.
• Format: Article
• Language: English
• Subjects: corrosive cast; inferior vena cava; Liver hanging maneuver; liver transplantation
• ISSN: 1365-182X; 1477-2574
• DOI: 10.1080/13651820500465931

Background. An anatomical study was carried out to evaluate the safety of the liver hanging maneuver for the right hemiliver in living donor and in situ splitting transplantation. During this procedure a 4–6cm blind dissection is performed between the inferior vena cava and the liver. Short subhepatic veins entering the inferior vena cava from segments 1 and 9 could be torn with consequent hemorrhage. Materials and methods. One hundred corrosive casts of livers were evaluated to establish the position and diameter of short subhepatic veins and the inferior right hepatic vein. Results. The average distance from the right border of the inferior vena cava to the opening of segment 1 veins was 16.7±3.4mm and to the entrance of segment 9 veins was 5.0±0.5mm. The width of the narrowest point on the route of blind dissection was determined, with the average value being 8.7±2.3mm (range 2–15mm). Discussion. The results show that the liver hanging maneuver is a safe procedure. A proposed route of dissection minimizes the risk of disrupting short subhepatic veins (7%).