Journal of hepato-biliary-pancreatic surgery · 2004
Feasibility of hanging maneuvers in orthotopic liver transplantation with inferior vena cava preservation and in liver surgery.
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Ettorre Giuseppe Maria, Vennarecci Giovanni, Boschetto Arianna, Douard Richard, Santoro Eugenio
Аннотация
BACKGROUND/PURPOSE: The aim of this work was to study the feasibility and complication rates of liver hanging maneuvers: the Belghiti liver hanging maneuver (BLHM) in liver resection and the modified liver hanging maneuver (MLHM) in orthotopic liver transplantation (OLT) with inferior vena cava (IVC) preservation.
METHODS: From January 2001 to August 2003, BLHM was planned in 26 consecutive right hepatectomies and MLHM in 28 consecutive OLTs with IVC preservation.
RESULTS: BLHM was performed in 24/26 patients (92%). In the 2 remaining patients, chronic biliary infection (n = 1) and intraparenchymal hemorrhagic hepatocellular carcinoma (n = 1) did not allow BLHM to be achieved. Bleeding during the BLHM procedure occurred in 1 patient (4%), with no need for interruption. MLHM was performed in all 28 patients, and in none of them was bleeding observed during the maneuver.
CONCLUSIONS: BLHM and MLHM are important technical refinements with several advantages. Feasibility rates were 92% and 100%, respectively. Bleeding risk remained low (4%) for BLHM and was 0% for MLHM. The rate of BLHM failure suggests that the feasibility rate may be higher in normal liver parenchyma.
METHODS: From January 2001 to August 2003, BLHM was planned in 26 consecutive right hepatectomies and MLHM in 28 consecutive OLTs with IVC preservation.
RESULTS: BLHM was performed in 24/26 patients (92%). In the 2 remaining patients, chronic biliary infection (n = 1) and intraparenchymal hemorrhagic hepatocellular carcinoma (n = 1) did not allow BLHM to be achieved. Bleeding during the BLHM procedure occurred in 1 patient (4%), with no need for interruption. MLHM was performed in all 28 patients, and in none of them was bleeding observed during the maneuver.
CONCLUSIONS: BLHM and MLHM are important technical refinements with several advantages. Feasibility rates were 92% and 100%, respectively. Bleeding risk remained low (4%) for BLHM and was 0% for MLHM. The rate of BLHM failure suggests that the feasibility rate may be higher in normal liver parenchyma.