Development and clinical usefulness of the liver hanging maneuver in various anatomical hepatectomy procedures

Abstract

We conclude that the application of LHM is an important development in the field of liver surgery, although a further evaluation of its true impact on clinical outcomes is necessary.

Laparoscopic Right Hepatectomy by the Caudal Approach Versus Conventional Approach: A Comparative Study

“…In fact, the liver-hanging maneuver, first described by Belghiti et al, 36 was commonly thought to facilitate the anterior approach to acquire better vascular control and improve operative outcomes of liver resections. 25,41,42 In cases with the retrohepatic tunnel only partially established (5 patients in our study), the Goldfinger dissector can be inserted through the avascular area anterior to the IVC when the partial liver parenchyma is transected to provide elevating and protective effects, consistent with the previous report by Troisi and Montalti. 43 Moreover, the Goldfinger dissector contributes to the safe establishment of the retrohepatic tunnel and is widely used in LRH 43 because it is atraumatic with an angled shape and has strong consistency to support the liver.…”

Significance of liver hanging maneuver for anatomical hepatectomy in patients with a large hepatocellular carcinoma compressing intrahepatic vasculatures

“…Since the report of LHM by Belghiti et al, 5 it has been widely applied in liver resection. 5 6 7 8 9 10 11 20 21 22 23 24 In hepatic malignancy, mobilization or rotation of the resected liver with a liver tumor should be avoided to prevent tumor dissemination during operation. 23 In patients with a large tumor or a tumor that invades adjacent organs, anterior liver transection through the LHM procedure is preferred.…”

“… 5 6 7 8 Recently, this technique has been applied for various anatomical resections. 9 10 According to recent development of hepatic transection, the deeper part seemed to be lifted. In a large-size HCC, the trunk of the Glissonian pedicle, including the intrahepatic vasculature and hepatic veins, is often severely compressed.…”

Effects of implementing an “enhanced recovery after surgery” program on patients undergoing resection of hepatocellular carcinoma

“…Postoperative serum concentrations of albumin and develop in patients with chronic hepatitis and liver cirrhosis induced by hepatitis B or C virus infection. With advances in perioperative management, anesthesia, and operative techniques, hepatectomy for HCC is being performed more commonly [13]. However, the postoperative mortality rate of these patients remains higher than that of patients with cirrhosis or chronic hepatitis undergoing other types of surgery.…”