Laparoscopic-specific procedure using dorsal approach to the middle hepatic vein in laparoscopic left hemihepatectomy

2020 ◽  
Vol 35 ◽  
pp. 139-140
Author(s):  
Masaki Ueno ◽  
Shinya Hayami ◽  
Masashi Nakamura ◽  
Hiroki Yamaue
Keyword(s):  
Hepatic Vein ◽  
Middle Hepatic Vein ◽  
Specific Procedure ◽  
Dorsal Approach ◽  
Left Hemihepatectomy

Dorsal Approach to the Middle Hepatic Vein in Laparoscopic Left Hemihepatectomy

2014 ◽  
Vol 219 (2) ◽  
pp. e1-e4 ◽  
Author(s):  
Yukihiro Okuda ◽  
Goro Honda ◽  
Masanao Kurata ◽  
Shin Kobayashi ◽  
Katsunori Sakamoto
Keyword(s):  
Hepatic Vein ◽  
Middle Hepatic Vein ◽  
Dorsal Approach ◽  
Left Hemihepatectomy

Rescue partial ALPPS for left hemihepatectomy with reconstruction of the middle hepatic vein

2021 ◽  
Author(s):  
Masaharu Kogure ◽  
Takaaki Arai ◽  
Hirokazu Momose ◽  
Ryota Matsuki ◽  
Yutaka Suzuki ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Vein ◽  
Retention Rate ◽  
Liver Volume ◽  
Future Liver Remnant ◽  
Middle Hepatic Vein ◽  
Liver Remnant ◽  
Total Liver Volume ◽  
Left Hemihepatectomy ◽  
Icg R15

Major hepatectomy in patients with insufficient future liver remnant (FLR) volume and impaired liver functional reserve has considerable risks for posthepatectomy liver failure (PHLF). The patient was a male in his 70 with an intrahepatic cholangiocarcinoma (ICC) in left hemiliver, involving the middle hepatic vein (MHV). Although FLR volume after left hemihepatectomy was estimated to be 64.4% of the total liver volume, an indocyanine green retention rate at 15 min (ICG-R15) value was 24.2%, thus the patient underwent left portal vein embolization (PVE). The FLR volume increased to 71.3%, however, the non-congestive FLR volume was re-estimated as 45.8% after resection of the MHV, the ICG-R15 value was 29.0%, and ICG-Krem was calculated as 0.037. We performed partial rescue ALPPS (Associating Liver Partition and Portal vein occlusion for Staged hepatectomy) for left hemihepatectomy with the MHV reconstruction. On the first stage, partial liver partition was done along Rex-Cantlie’s line, preserving the MHV and sacrificing the remaining branches to segment 8. The FLR volume increased to 77.4% on day 14. The ICG-R15 value was 29.6%, but ICG-Krem after MHV reconstruction was estimated to be 0.059. The second stage operation on day 21 was left hemihepatectomy with the MHV reconstruction using the left superficial femoral vein graft. The usage of rescue partial ALPPS may contribute to preventing PHLF by introducing occlusion of the portal and/or venous branches in the left hemiliver before curative hepatectomy.

LEFT HEMIHEPATECTOMY IN LIVING DONORS WITH A THICK MIDDLE HEPATIC VEIN DRAINING THE CAUDAL HALF OF THE RIGHT LIVER

2000 ◽  
Vol 69 (7) ◽  
pp. 1499-1501 ◽  
Author(s):  
Ai-Min Hui ◽  
Masatoshi Makuuchi ◽  
Tadatoshi Takayama ◽  
Keiji Sano ◽  
Keiichi Kubota ◽  
...  
Keyword(s):  
Hepatic Vein ◽  
Middle Hepatic Vein ◽  
Living Donors ◽  
Left Hemihepatectomy ◽  
The Right

scholarly journals Successful use of the left portal vein as graft for middle hepatic vein reconstruction in left hemihepatectomy: preliminary experience on six cases

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Tao Lv ◽  
Ling Xiang Kong ◽  
Jiayin Yang ◽  
Hong Wu ◽  
Tianfu Wen ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Vein ◽  
Liver Tumors ◽  
Operating Time ◽  
Bile Leakage ◽  
Middle Hepatic Vein ◽  
Graft Patency ◽  
Hepatic Vein Reconstruction ◽  
Left Portal Vein ◽  
Left Hemihepatectomy

Abstract Background The purpose of this research was to assess the feasibility of reconstructing the middle hepatic vein (MHV) with resected left portal vein during left hemihepatectomy. Methods From January 2014 to January 2018, six patients received left hemihepatectomy combined with MHV reconstruction using the resected left portal vein in West China Hospital. We reviewed the clinical data including patient details, surgical technique, graft patency, and operative results. Results All six patients underwent left hemihepatectomy for liver tumors located at left hepatocaval confluence. In these patients, MHV was resected due to tumor invading and reconstructed using the resected left portal vein as graft. The mean operating time was 316 min. Two patients developed complications: one experienced bile leakage and one experienced pleural effusion. No patient developed vascular graft complications. All the grafts remained unobstructed, and no local tumor recurrence occurred during the observation period of 13–41 months. Conclusions Our results indicated that the left portal vein was a safe graft for hepatic vein reconstruction. In addition, left hemihepatectomy combined with middle hepatic vein resection and reconstruction using the left portal vein can be performed safely to treat liver tumors located at hepatocaval confluence.

scholarly journals Dorsal approach with Glissonian approach for laparoscopic right anatomic liver resections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaohe Wang ◽  
Yang Yue ◽  
Wenjie Zhang ◽  
Qiaoyu Liu ◽  
Beicheng Sun ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Hepatic Vein ◽  
Pringle Maneuver ◽  
Caudate Lobe ◽  
Postoperative Hospital Stay ◽  
Dorsal Approach ◽  
Glissonian Approach ◽  
The Mean ◽  
Major Hepatic Vein

Abstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal approach combined with Glissionian appraoch to perform laparoscopic right anatomic hepatectomy (LRAH). Methods Twenty patients who underwent LRAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). The paracaval portion of caudate lobe could be transected firstly through dorsal approach and the corresponding major hepatic vein could be exposed from its root to the peripheral branches safely. Due to exposure along the major hepatic vein trunk, the remaining liver parenchyma could be quickly transected from dorsal to cranial side. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusions Dorsal approach combined with Glissonian approach for right lobe is feasible and effective in laparoscopic right anatomic liver resections.

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