Liver Resection for Non-Oriental Hepatolithiasis

Ojm, Torres; Linhares, Marcelo Moura; Ramos, Eduardo J.B.; Pcg, Amaral; Belotto, Marcos; Lucchese, A M; Rf, Neiva; Tm, Freitas; Santana, Roberta Silva de Souza; Jp, Vieira; Js, Freire; Ccs, Torres; An, Kalil

doi:10.1590/0102-672020190001e1463

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…This kind of tube is firm and works perfectly to occlude blood inflow as the cotton band is tightened. It has an internal diameter of 5,5 mm, sufficient for a laparoscopic INTRODUCTION L aparoscopic liver resection (LLR) is a reality and is performed worldwide for almost all types of liver surgeries, from edge resections to adult living donors 2,9 . Hemorrhage is still a major complication and bleeding control during hepatic transection is an important concern.…”

Section: Discussionmentioning

confidence: 99%

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External Pringle Maneuver in Laparoscopic Liver Resection: A Safe, Cheap and Reproducible Way to Perform It

Steinbrück

Fernandes

D'Oliveira³

et al. 2020

ABCD, arq. bras. cir. dig.

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Background: Laparoscopic liver resection is performed worldwide. Hemorrhage is a major complication and bleeding control during hepatotomy is an important concern. Pringle maneuver remains the standard inflow occlusion technique. Aim: Describe an extracorporeal, efficient, fast, cheap and reproducible way to execute the Pringle maneuver in laparoscopic surgery, using a chest tube. Methods: From January 2014 to March 2020, our team performed 398 hepatectomies, 63 by laparoscopy. We systematically encircle the hepatoduodenal ligament and prepare a tourniquet to perform Pringle maneuver. In laparoscopy, we use a 24 Fr chest tube, which is inserted in the abdominal cavity through a small incision. We thread the cotton tape through the tube, pulling it out through the external end, outside the abdomen. To perform the tourniquet, we just need to push the tube as we hold the tape, clamping both with one forceps. Results: The 24 Fr chest tube is firm and works perfectly to occlude blood inflow as the cotton band is tightened. It has an internal diameter of 5,5 mm, sufficient for a laparoscopic grasper pass through it to catch the cotton band, and an external diameter of 8 mm, which allows to be inserted in the abdomen through a tiny incision. The cost of this tube and the cotton band is less than US$ 1. No complications related to the method were identified in our patients. Conclusions: The extracorporeal Pringle maneuver presented here is a safe, cheap and reproducible method, that can be used for bleeding control in laparoscopic liver surgery.

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Section: Discussionmentioning

confidence: 99%

“…Laparoscopic liver resection (LLR) is a reality and is performed worldwide for almost all types of liver surgeries, from edge resections to adult living donors 2 , 9 . Hemorrhage is still a major complication and bleeding control during hepatic transection is an important concern.…”

Section: Introductionmentioning

confidence: 99%

External Pringle Maneuver in Laparoscopic Liver Resection: A Safe, Cheap and Reproducible Way to Perform It

Steinbrück

Fernandes

D'Oliveira³

et al. 2020

ABCD, arq. bras. cir. dig.

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“…Hepatectomy reduces the risk of stone recurrence and progression to CCA[ 21 , 89 ]. Hence, in patients with bilateral disease, hepatic atrophy and who can tolerate a more major operation, anatomical resection of all liver segments affected by the disease is the ideal treatment.…”

Section: Managementmentioning

confidence: 99%

Hepatolithiasis: Epidemiology, presentation, classification and management of a complex disease

Motta,

Saffioti,

Mavroeidis

2024

World J Gastroenterol

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The term hepatolithiasis describes the presence of biliary stones within the intrahepatic bile ducts, above the hilar confluence of the hepatic ducts. The disease is more prevalent in Asia, mainly owing to socioeconomic and dietary factors, as well as the prevalence of biliary parasites. In the last century, owing to migration, its global incidence has increased. The main pathophysiological mechanisms involve cholangitis, bile infection and biliary strictures, creating a self-sustaining cycle that perpetuates the disease, frequently characterised by recurrent episodes of bacterial infection referred to as syndrome of “recurrent pyogenic cholangitis”. Furthermore, long-standing hepatolithiasis is a known risk factor for development of intrahepatic cholangiocarcinoma. Various classifications have aimed at providing useful insight of clinically relevant aspects and guidance for treatment. The management of symptomatic patients and those with complications can be complex, and relies upon a multidisciplinary team of hepatologists, endoscopists, interventional radiologists and hepatobiliary surgeons, with the main goal being to offer relief from the clinical presentations and prevent the development of more serious complications. This comprehensive review provides insight on various aspects of hepatolithiasis, with a focus on epidemiology, new evidence on pathophysiology, most important clinical aspects, different classification systems and contemporary management.

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“…Hepatolithiasis commonly occurs in the bile duct proximal to the confluence of the right and left hepatic ducts, regardless of the coexistence of gallstones in gallbladder or the common bile duct. [ 1 – 3 ] The incidence rate is 3.1% to 21.2%, mostly in Asia-Pacific region, such as China, Japan, and Korea. [ 4 ] The obstruction caused by stone could lead to bile duct inflammation, stenosis, and liver fibrosis, and it may even further cause liver atrophy or malignant transformation to lead to serious complications of biliary tract and the whole system, which is the common cause of death in nonmalignant diseases of biliary tract.…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy and advantages of minimally invasive hepatectomy for hepatolithiasis

Jianyang

Xu²,

Luo

et al. 2020

Medicine

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Background: Hepatolithiasis commonly occurs in the bile duct proximal to the confluence of the right and left hepatic ducts, regardless of the coexistence of gallstones in gallbladder or the common bile duct. Clinical research proves that minimally invasive surgery is effective in the treatment of hepatolithiasis. Although previous meta-analysis also shows that it could reduce intraoperative bleeding and blood transfusion, and shorten hospital stay time, there are few meta-analyses on its long-term efficacy. We conducted the meta-analysis and systematic review to systematically evaluate the long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis. Methods: Articles of randomized controlled trials will be searched in the PubMed, Medline, Embase, Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP Chinese Science and Technology Periodical Database, Chinese Biological and Medical database, and Wanfang database until September, 2020. Literature extraction and risk of bias assessment will be completed by 2 reviewers independently. Statistical analysis will be conducted in RevMan 5.3. Results: This study will summarize the present evidence by exploring the long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis Conclusions: The findings of the study will help to determine potential long-term efficacy and advantages of minimally invasive hepatectomy in the treatment of hepatolithiasis. Ethics and dissemination: The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF Registration number: DOI 10.17605/OSF.IO/H6WRV.

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Liver Resection for Non-Oriental Hepatolithiasis

Cited by 5 publications

References 21 publications

External Pringle Maneuver in Laparoscopic Liver Resection: A Safe, Cheap and Reproducible Way to Perform It

External Pringle Maneuver in Laparoscopic Liver Resection: A Safe, Cheap and Reproducible Way to Perform It

Hepatolithiasis: Epidemiology, presentation, classification and management of a complex disease

Long-term efficacy and advantages of minimally invasive hepatectomy for hepatolithiasis

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