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Modified liver hanging maneuver with extraparenchymal isolation of the middle hepatic vein in left hepatectomy
Author(s) -
Sugiyama Masanori,
Suzuki Yutaka,
Abe Nobutsugu,
Masaki Tadahiko,
Mori Toshiyuki,
Atomi Yutaka
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-008-0024-z
Subject(s) - hepatectomy , medicine , inferior vena cava , anatomy , parenchyma , vein , hepatic veins , surgery , resection , pathology
Background/purpose The liver hanging maneuver has been employed mostly for right hepatectomy. After the space between the inferior vena cava and the liver parenchyma is bluntly dissected, a tape is passed through the space, with the upper end of the tape between the right hepatic vein and middle hepatic vein (MHV). We devised a modified maneuver with tape repositioning between the MHV and left hepatic vein (LHV) after extraparenchymal isolation of the MHV, in left hepatectomy with the caudate lobe and without the MHV. Methods The ligamentum venosum is divided. Traction of the cranial stump of the ligament in the cranial and left direction shows an avascular plane between the LHV and MHV, and enables the taping of each MHV and LHV. Finally, the upper end of the hanging tape is repositioned. Results This maneuver was successfully performed in three patients. Conclusions The present maneuver is feasible and useful in left hepatectomy.