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Isolated sling suspension during resection of the Spiegel lobe of the liver: a safe alternative technique for difficult cases
Author(s) -
Shindoh Junichi,
Imamura Hiroshi,
Kokudo Norihiro
Publication year - 2010
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-010-0274-4
Subject(s) - medicine , surgery , lobe , resection , sling (weapon) , dissection (medical) , inferior vena cava , left lobe , anatomy
Background/purpose The Spiegel lobe is located deep in the dorsal portion of the liver, and isolated resections of this region are technically demanding, especially in bulky and/or invasive lesions or in hypertrophied cirrhotic livers. Methods Anterior approach using the isolated hanging maneuver of the Spiegel lobe was attempted in patients in whom the conventional method of mobilizing the Spiegel lobe prior to liver transection would have been difficult. Clinical outcomes were compared with the conventional approach performed during the same period. Results Of 42 consecutive isolated resections of the Spiegel lobe, the presently reported technique was required in 12 patients (28.6%). The median diameter of the tumors was 33 mm, and tumor invasion to the retrohepatic inferior vena cava was observed in four patients. Although minor vascular injury was observed in one patient during retrohepatic dissection, the isolated sling suspension of the Spiegel lobe was successfully conducted in all cases. No remarkable inferiority of the present technique compared with the conventional approach was noted either in operation data or clinical outcomes. Conclusion Anterior approach using the isolated sling‐suspension technique may be a safe alternative surgical option for bulky and/or invasive lesions located in the Spiegel lobe of the liver.