Fixation of the round ligament to the peritoneum and wrapping of the cut surface of the liver for prevention of early delayed gastric emptying after hepatic lateral segmentectomy.

PURPOSE: Left-sided hepatectomy occasionally leads to early delayed gastric emptying (EDGE). We developed a new fixation procedure of the round ligament to the peritoneum to prevent EDGE after hepatic lateral segmentectomy and evaluated its efficacy.

METHODS

We retrospectively studied 42 patients who underwent hepatic lateral segmentectomy. They were divided into two groups: a fixation group (N = 15) and a nonfixation group (N = 27). The round ligament of the liver was divided at the umbilicus and detached from the abdominal wall from the umbilicus to the liver. The cut surface of the liver was wrapped by the round ligament, and the distal part of the round ligament was then fixated to the peritoneum.

RESULTS

EDGE was found to be 0% in the fixation group versus 15% in the nonfixation group.

CONCLUSIONS

Fixation of the round ligament to the peritoneum is a useful technique to prevent EDGE after hepatic lateral segmentectomy.