scholarly journals How Far Can We Go with Laparoscopic Liver Resection for Hepatocellular Carcinoma? Laparoscopic Sectionectomy of the Liver Combined with the Resection of the Major Hepatic Vein Main Trunk

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Zenichi Morise ◽  
Norihiko Kawabe ◽  
Hirokazu Tomishige ◽  
Hidetoshi Nagata ◽  
Jin Kawase ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Vein ◽  
Laparoscopic Liver Resection ◽  
Operating Time ◽  
Hepatic Veins ◽  
Peripheral Part ◽  
Main Trunk ◽  
Hepatocellular Carcinomas ◽  
Vein Resection ◽  
Major Hepatic Vein

Although the reports of laparoscopic major liver resection are increasing, hepatocellular carcinomas (HCCs) close to the liver hilum and/or major hepatic veins are still considered contraindications. There is virtually no report of laparoscopic liver resection (LLR) for HCC which involves the main trunk of major hepatic veins. We present our method for the procedure. We experienced 6 cases: 3 right anterior, 2 left medial, and 1 right posterior extended sectionectomies with major hepatic vein resection; tumor sizes are within 40–75 (median: 60) mm. The operating time, intraoperative blood loss, and postoperative hospital stay are within 341–603 (median: 434) min, 100–750 (300) ml, and 8–44 (18) days. There was no mortality and 1 patient developed postoperative pleural effusion. For these procedures, we propose that the steps listed below are useful, taking advantages of the laparoscopy-specific view. (1) The Glissonian pedicle of the section is encircled and clamped. (2) Liver transection on the ischemic line is performed in the caudal to cranial direction. (3) During transection, the clamped Glissonian pedicle and the peripheral part of hepatic vein are divided. (4) The root of hepatic vein is divided in the good view from caudal and dorsal direction.

scholarly journals Impact of Intraoperative Gravity-Dependent Atelectasis Following Laparoscopic Liver Resection Performed in the Lateral Position

2021 ◽  
Author(s):  
Ryoichi Miyamoto ◽  
Toshiro Ogura ◽  
Amane Takahashi ◽  
Akifumi Kimura ◽  
Shinichi Matsudaira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Resection ◽  
Postoperative Complications ◽  
Laparoscopic Liver Resection ◽  
Operating Time ◽  
Multivariate Logistic Regression Analysis ◽  
Lateral Position ◽  
Cancer Center ◽  
Related Factors ◽  
Left Half

Abstract Purpose Laparoscopic liver resection (LLR) is currently an accepted approach for liver surgery in select patients. The correlation between the intraoperative position and the presence of gravity-dependent atelectasis (GDA) has been well discussed. However, LLR is performed in the left half lateral position, and the relationship between this position and the presence of GDA remains unclear. We evaluated the extent to which the intraoperative left half lateral position affects the presence of GDA. Furthermore, univariate and multivariate analyses were performed to identify potential risk factors for LLR postoperative complications with a special emphasis on the presence of GDA by comparing various patient-, liver- and surgery-related factors in a retrospective cohort. Methods We retrospectively evaluated 129 patients who underwent LLR in the left half lateral position at the Saitama Cancer Center in Saitama, Japan between March 2011 and July 2020. The frequency and duration of GDA were investigated. We divided the cohort into with GDA and without GDA groups based on a cutoff value (≥ 5 days, n = 61 and < 5 days, n = 68, respectively). Using multivariate analysis, the duration of GDA and several risk factors for LLR postoperative complications were independently assessed. Results Postoperative GDA was observed in 61 patients (47%) and lasted for 1 to 8 days in these patients. The mean duration of GDA was 4.3 days. Multivariate logistic regression analysis revealed a GDA duration of 5 days or more (odds ratio [OR], 2.03; p = 0.001) and an operating time > 388 minutes (OR, 5.31; p < 0.001) to be independent risk factors for LLR postoperative complications. Conclusions The incidence and duration of postoperative GDA are considered useful predictors of postoperative complications, and these predictors should be assessed to improve the short-term outcomes of patients undergoing LLR.

Are Large Hepatocellular Carcinomas Still a Contraindication for Laparoscopic Liver Resection?

2015 ◽  
Vol 25 (2) ◽  
pp. 98-102 ◽  
Author(s):  
Yujin Kwon ◽  
Ho-Seong Han ◽  
Yoo-Seok Yoon ◽  
Jai Young Cho
Keyword(s):  
Liver Resection ◽  
Laparoscopic Liver Resection ◽  
Hepatocellular Carcinomas

Laparoscopic liver resection in segment 7: Hepatic vein first approach with special reference to sufficient resection margin

2019 ◽  
Vol 30 ◽  
pp. 87-89 ◽  
Author(s):  
Boram Lee ◽  
Jai Young Cho ◽  
YoungRok Choi ◽  
Yoo-Seok Yoon ◽  
Ho-Seong Han
Keyword(s):  
Liver Resection ◽  
Special Reference ◽  
Hepatic Vein ◽  
Laparoscopic Liver Resection ◽  
Resection Margin

scholarly journals Single Port Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Preliminary Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Stephen Kin Yong Chang ◽  
Maria Mayasari ◽  
Iyer Shridhar Ganpathi ◽  
Victor Lee Tswen Wen ◽  
Krishnakumar Madhavan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Laparoscopic Surgery ◽  
Liver Resection ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Liver Resection ◽  
Preliminary Report ◽  
Single Port ◽  
Operating Time ◽  
Length Of Hospital Stay

Single port laparoscopic surgery is an emerging technique, now commonly used in cholecystectomy. The experience of using this technique in liver resection for hepatocellular carcinoma is described in a series of 3 cases with single port laparoscopic liver resection performed during 2010. All patients were male aged 61 to 70 years, with several comorbidities. There were no complications in this early series. The length of hospital stay was 3–5 days. The blood loss was 200–450 mL, with operating time between 142 and 171 minutes. We conclude that this technique is feasible and safe to perform in experienced centers.

scholarly journals Multivariate analysis of preoperative risk factors for prolonged operating time in laparoscopic liver resection

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S973-S974
Author(s):  
A. Sultana ◽  
R.P. Sutcliffe ◽  
K.J. Roberts ◽  
P. Muiesan ◽  
P. Nightingale ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Liver Resection ◽  
Laparoscopic Liver Resection ◽  
Operating Time ◽  
Preoperative Risk ◽  
Preoperative Risk Factors

scholarly journals Revisiting the role of the hepatic vein in laparoscopic liver resection

2021 ◽  
Vol 2021 ◽  
Author(s):  
Daisuke Ban ◽  
Satoshi Nara ◽  
Takeshi Takamoto ◽  
Takahiro Mizui ◽  
Jun Yoshino ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Vein ◽  
Laparoscopic Liver Resection

scholarly journals Ex Vivo Liver Resection and Autotransplantation as Surgical Option for Zone II–III Leiomyosarcoma of IVC: A Case Report and Literature Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Tuerhongjiang Tuxun ◽  
Tao Li ◽  
Shadike Apaer ◽  
Yi-Biao He ◽  
Lei Bai ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Vein ◽  
Ex Vivo ◽  
Three Dimensional ◽  
Vena Cava ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Hepatic Recurrence ◽  
Chiari Syndrome ◽  
Zone Ii

We report the first documented case of leiomyosarcoma at zone II-III of inferior vena cava with thrombi in three hepatic veins undergoing ex vivo liver resection and autotransplantation (ELRA) and hepatic veins thrombectomy. A 33-year-old female patient presented with abdominal distention and lower extremities edema. Abdominal wall varicosis and shifting dullness were positive on physical examination. Her liver function was classified as Child-Pugh B and a solid tumor at retro-hepatic vena cava extending to right atrium with thrombi in three hepatic veins were confirmed. The diagnosis of leiomyosarcoma with Budd-Chiari syndrome was highly suspected with preoperative ultrasound, echocardiogram, CT scan, and three-dimensional reconstruction. A zone II-III leiomyosarcoma of IVC origin was confirmed at surgery and ex vivo liver resection and autotransplantation, and hepatic vein thrombectomy with atrial reconstruction were performed under cardiopulmonary bypass (CPB). Operative time, anhepatic time, and CPB time were 12 h, 128 min, and 84 min, respectively. The patients experienced post-operative liver dysfunction and was cured with conservative therapy. Hepatic recurrence two years after surgery was managed with radiofrequency. The patient was alive with liver metastasis three years after surgery. Despite being regarded as an extremely aggressive procedure, ELRA could be considered in the treatment of advanced leiomyosarcoma with Budd-Chiari syndrome and hepatic vein thrombi.

scholarly journals Hanging manuever in liver trauma

2010 ◽  
Vol 57 (4) ◽  
pp. 53-56
Author(s):  
Vladimir Djukic ◽  
Aleksandar Karamarkovic ◽  
Dejan Radenkovic ◽  
Pavle Gregoric ◽  
Vasilije Jeremic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Liver Resection ◽  
Hepatic Vein ◽  
Intensive Therapy ◽  
Trauma Surgery ◽  
Liver Trauma ◽  
Hepatic Veins ◽  
Trauma Patients ◽  
Suture Materials ◽  
Hanging Maneuver

The philosophy of aggressive surgical approach, its complete implementation in liver trauma surgery did not appear efficient. No matter of permanenent development of diagnostic imaging methods, anesthesia, intensive therapy, medical technology and suture materials, operational theater and operative techniques, major liver resections in trauma had mortality rate up to 60%. With introduction of computerized tomography ( CT,1981) in everyday clinical praxis and with better evaluation of trauma patients, the whole approach to liver trauma patient has been redesigned. Based on AAST - OIS classification, almost 70% of traumatized with grade I,II and III should be treated non - operatively, hospitally, with repeating FAST (focused abdominal ultrasound in trauma) and abdominal CT scans. The rest of traumatized patients, with grade IV and V injuries of juxtahepatic structures demand complexive surgical treatment. The modalities of surgical treatment depend on trauma mechanisms, extensivity, anatomical localization and affection of vascular structures. Hanging Manuevr- the Method of French surgeon Belghiti bases on anterior approach in liver resection is a try for fast solution for fatal bleeding in liver trauma. It consists of placing the elastic cord throughout the anterior surface of VCI or ligamentum venosusm, of upper end of the cord is located in superior part of VCI where hepatic veins are emerging. Lower end of the cord is located in subhepatic part of VCI between 3 Glisonian pedicles. Concerning hepatic veins liver is divided in 3 sections, which derives blood in right hepatic vein RHV, middle hepatic vein MHV and left hepatic vein LHV. Belghiti proposed the usage of hanging maneuver when resecting the right liver, while the cord is placed throughout retrohepatic VCI, lower end between elements of Glisonian pedicle and upper end between hepatic veins. Complications like bleeding from caudal veins are minimal, then speed in liver resection in hemodynamic unstable and ishemic patient, defects like bleeding because compressing tapes or lesions IVC tile mobilazion of liver for conventional resection.

scholarly journals Laparoscopic Liver Resection in Segment 7: Hepatic vein first approach with special reference to sufficient resection margin

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S212
Author(s):  
Boram Lee ◽  
Jai Young Cho ◽  
YoungRok Choi ◽  
Yoo-Seok Yoon ◽  
Ho-Seong Han
Keyword(s):  
Liver Resection ◽  
Special Reference ◽  
Hepatic Vein ◽  
Laparoscopic Liver Resection ◽  
Resection Margin
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