Laparoscopic Parenchymal-Sparing Liver Resections Using the Intrahepatic Glissonian Approach

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...

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Bibliographic Details
Published in:Annals of surgical oncology 2017-08, Vol.24 (8), p.2353-2354
Main Authors: Machado, Marcel Autran C., Surjan, R., Basseres, T., Makdissi, F.
Format: Article
Language:English
Subjects:
Hepatectomy
Hepatectomy - methods
Hepatobiliary Tumors
Humans
Intraoperative Care
Laparoscopy
Laparoscopy - methods
Liver
Liver - surgery
Liver diseases
Liver Neoplasms - surgery
Medicine
Medicine & Public Health
Oncology
Organ Sparing Treatments
Parenchyma
Parenchymal Tissue - surgery
Surgery
Surgical Oncology
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Summary: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.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-017-5886-3