Modified liver-hanging maneuver designed to minimize blood loss during hepatic parenchymal transection in hemihepatectomy

Purpose We evaluated the efficiency of a modified liver-hanging technique for minimizing intraoperative blood loss during right and left hemihepatectomy. Methods The lower end of the hanging tape was repositioned between the parenchyma of the left paramedian sector and the hilar plate. The upper end...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2010-03, Vol.40 (3), p.239-244
Main Authors: Akamatsu, Nobuhisa, Sugawara, Yasuhiko, Shin, Nobuhiro, Ishida, Takashi, Shirakawa, Kazuo, Ozawa, Fumiaki, Hoshino, Takanobu, Hashimoto, Daijo
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Blood Loss, Surgical - prevention & control
Female
Gallbladder Neoplasms - surgery
Hepatectomy - methods
Humans
Liver - surgery
Liver Diseases - surgery
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Surgery
Surgical Oncology
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Summary:Purpose We evaluated the efficiency of a modified liver-hanging technique for minimizing intraoperative blood loss during right and left hemihepatectomy. Methods The lower end of the hanging tape was repositioned between the parenchyma of the left paramedian sector and the hilar plate. The upper end of the tape was positioned between the right hepatic vein and middle hepatic vein for right hepatectomy (Belghiti), and between the middle hepatic vein and left hepatic vein for left hepatectomy. The tape was positioned prior to the parenchymal transection. We compared the results of this operative technique, performed in 15 recent patients, with those of conventional hemihepatectomy performed in 14 earlier patients. Results There were no intergroup differences in baseline characteristics or postoperative outcomes. Intraoperative blood loss ( P = 0.02), especially blood loss during the parenchymal transection ( P = 0.005), was significantly less in patients undergoing the modified technique. Multivariate analysis revealed that this modified liver-hanging technique offered a significant advantage in blood-loss reduction during parenchymal transection over the conventional techniques ( P = 0.005). Conclusion Using the liver-hanging technique during hemihepatectomy could be crucial for liver surgeons.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-008-4060-8