The liver hanging maneuver in laparoscopic liver resection: a systematic review

Rhaiem, Rami; Piardi, Tullio; Kellil, Tarek; Cagniet, A.; Chetboun, Mikaël; Kianmanesh, Réza; Sommacale, Danièle

doi:10.1007/s00595-017-1520-z

Cited by 7 publications

(6 citation statements)

References 36 publications

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“…Recently, a systematic review which aimed to investigate the effectiveness of the LHM in laparoscopic hepatectomy (LH) showed inadequate evidence to support the systematic use of LHM in laparoscopic surgery. 11 Most of the series described the practice of LHM in LH were modified techniques that used either transection of the parenchyma or prior mobilization of liver before passing a tape. 11 Thus, neither fulfilled the principles of the original description of LHM in open liver resection.…”

Section: Hpb Discussionmentioning

confidence: 99%

“…11 Most of the series described the practice of LHM in LH were modified techniques that used either transection of the parenchyma or prior mobilization of liver before passing a tape. 11 Thus, neither fulfilled the principles of the original description of LHM in open liver resection. When performing LH with the LHM, the parenchyma is always transected from the lower edge of liver rather than the anterior surface of liver to the inferior vena cava.…”

Section: Hpb Discussionmentioning

confidence: 99%

“…38 While the effectiveness of LHM is not obvious in LH because it is difficult to compress the parenchyma from behind to act as a hemostatic tool. 11 Besides, one of primary advantages of laparoscopic hepatectomy is decreased intraoperative blood loss achieved by pneumoperitoneum pressure. 16 However, there were several limitations that warrant consideration when interpreting the findings.…”

Section: Hpb Discussionmentioning

confidence: 99%

“…Recently, a systematic review aimed to investigate the effectiveness of the LHM in laparoscopic liver resection (LLR), showing inadequate evidence to support the systematic use of LHM in LLR. 11 The aim of the present study was to evaluate the effectiveness of the LHM for open hepatic resection including for different subgroups.…”

Section: Introductionmentioning

confidence: 99%

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Liver hanging maneuver versus conventional approach for open hepatectomy: a meta-analysis

Zhu

Huang

et al. 2019

HPB

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Background: This study aimed to compare the safety and efficacy of the liver hanging maneuver (LHM) versus conventional approach for open hepatectomy.Methods: A comprehensive medical literature search was performed. Perioperative outcomes and long-term survival outcomes were reported. Subgroup analyses were conducted according to surgical approaches, modification of LHM, geographical region and indications for liver resection. Results: A total of 16 studies including 1109 patients were enrolled. The LHM was performed on 471 (37%) patients. The pooled outcomes showed hepatectomy with the LHM was associated with less estimated blood loss [standard mean difference (SMD): −0.77, P < 0.001], lower intraoperative transfusion rate [odds ratio (OR): 0.28, P = 0.003], less transection time (SMD: −0.68, P = 0.01), shorter duration of hospitalization (SMD:−0.19, P = 0.004), lower total complication rate (OR: 0.63, P = 0.008) and longer overall survival [hazard ration (HR): 0.70, P = 0.002] compared to conventional open hepatectomy.Subgroup analyses showed similar outcomes to overall analyses. Conclusions:The present meta-analysis suggested that the LHM was a safe and feasible alternative to conventional open hepatectomy with better perioperative and long-term outcomes. It was unnecessary to combine the LHM with anterior approach (AA) in consideration of perioperative outcomes.

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Section: Hpb Discussionmentioning

confidence: 99%

Section: Hpb Discussionmentioning

confidence: 99%

Section: Hpb Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Liver hanging maneuver versus conventional approach for open hepatectomy: a meta-analysis

Zhu

Huang

et al. 2019

HPB

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“…However, it is questionable whether laparoscopic modified LHM fulfills the principles of the original open technique. A systematic review that focused on LHM during LLR clarified that LHM provided an advantage—reduced blood loss—only with regard to the identified transection plane . Generally, with modified LHM in LLR, the findings to date have been insufficient to support that it offers the same oncological benefit as LHM in open procedures or that it similarly preserves postoperative liver function.…”

Section: Liver Hanging Maneuvermentioning

confidence: 99%

Useful maneuvers for precise laparoscopic liver resection

Chanwat

2018

Asian J Endoscop Surgery

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Laparoscopic liver resection has evolved over the past decade and nearly replaced open exploration. This procedure not only provides comparable oncological outcomes, but it also has improved recovery after surgery. Many of the challenges presented by limitations of instruments and techniques have been overcome through adaptations and new developments, and it is possible that the remaining obstacles will be overcome within a few years. Moreover, as surgeons continue to gain experience, their technical knowledge has supported further improvement in minimally invasive approaches. This review examines every important procedures in performing a precise laparoscopic liver resection.

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