A Combined 'Hanging Liver Maneuver' and 'Intrahepatic Extra-Glissonian Approach' for Anatomical Right Hepatectomy: Technique Standardization, Results, and Correlation With Portal Pedicle Anatomy
| العنوان: | A Combined 'Hanging Liver Maneuver' and 'Intrahepatic Extra-Glissonian Approach' for Anatomical Right Hepatectomy: Technique Standardization, Results, and Correlation With Portal Pedicle Anatomy |
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| المؤلفون: | Vagner Birk Jeismann, Fabio F. Makdissi, Fabricio Ferreira Coelho, Bruno H Mattos, Jaime Arthur Pirola Kruger, Paulo Herman |
| المصدر: | Frontiers in Surgery Frontiers in Surgery, Vol 8 (2021) |
| بيانات النشر: | Frontiers Media S.A., 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | hanging liver maneuver, anatomy, RD1-811, intrahepatic glissonian approach, medicine.medical_treatment, Liver resections, 03 medical and health sciences, 0302 clinical medicine, hepatectomy, Blood loss, Methods, Medicine, business.industry, Operative mortality, Anatomy, Perioperative, Combined approach, portal pedicle, 030220 oncology & carcinogenesis, Operative time, 030211 gastroenterology & hepatology, Surgery, Hepatectomy, business, Hospital stay, colorectal liver metastasis |
| الوصف: | Background: The hanging liver maneuver and intrahepatic extra-Glissonian approach are distinct modalities to facilitate safe anatomical liver resections. This study reports a standardized combination of these techniques focusing on safety, results and correlation with portal pedicle anatomy in oncological patients.Method: Combined hanging liver maneuver and intrahepatic extra-Glissonian approach for anatomic right hepatectomy was described stepwise. Portal pedicle anatomy was correlated with the Glissonian approach failure and complications. Clinical characteristics of patients, perioperative outcomes, short and long-term survival rates were analyzed.Results: Thirty colorectal liver metastases patients submitted to the combined approach were evaluated. Anatomical variations of the right portal pedicle were present in 26.6%. Hanging liver maneuver was feasible in 100%, and Glissonian approach in 96.7% despite portal pedicle variations. Mean operative time was 326 min. Mean blood loss was 507 ml. Mean hospital stay was 8 days. There was no 90-day operative mortality and no significant morbidity. Oncological surgical margins were free. Overall and disease-free 5-year survival were 59 and 37%.Conclusion: Regardless of frequent anatomical variations of the right portal pedicle, the hanging liver maneuver, and intrahepatic extra-Glissonian approach can be combined, being useful for anatomical right hepatectomies in a safe and reproducible way in most patients. |
| اللغة: | English |
| تدمد: | 2296-875X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0bdb162c29c2c3161fe9424d67e5b916Test http://europepmc.org/articles/PMC8175898Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0bdb162c29c2c3161fe9424d67e5b916 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 2296875X |
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