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Laparoscopic left hemihepatectomy guided by indocyanine green fluorescence: A cranial-dorsal approach.
World J Gastrointest Surg
February 2024
Institute of Hepatobiliary Surgery, First Affiliated Hospital, Army Medical University, Chongqing 400038, China.
Background: Advancements in laparoscopic technology and a deeper understanding of intrahepatic anatomy have led to the establishment of more precise laparoscopic hepatectomy (LH) techniques. The indocyanine green (ICG) fluorescence navigation technique has emerged as the most effective method for identifying hepatic regions, potentially overcoming the limitations of LH. While laparoscopic left hemihepatectomy (LLH) is a standardized procedure, there is a need for innovative strategies to enhance its outcomes.
View Article and Find Full Text PDF[Applied anatomical study and clinical application of the caudate lobe boundary and ductal system of the liver].
Zhonghua Gan Zang Bing Za Zhi
October 2022
Department of General Surgery, the Ninth Hospital of Nanchang, Nanchang 330002, China.
To explore the relationship between the hepatic caudate lobe boundary and the ductal system so as to guide the identification of the anatomical relationship during liver surgery. The specific parts were observed and the liver parenchyma was removed according to 41 cadaveric liver autopsy specimens. The critical relationship between the hepatic caudate lobe and other ducts was observed to explore the reticular duct structure.
View Article and Find Full Text PDFLaparoscopic left hemihepatectomy using the extrahepatic Glissonean approach: Technical tips for entering gaps.
J Surg Oncol
December 2022
Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
There are two methods for selective inflow control from the liver hilum: individual hilar dissection and the Glissonean pedicle approach. The Glissonean pedicle approach has been increasingly used in laparoscopic anatomical liver resection. Recently, the extrahepatic Glissonean approach has been standardized due to the anatomical concept of Laennec's capsule.
View Article and Find Full Text PDFStandardized upfront Glissonean approach and liver hanging maneuver reduces bile leakage from the hepatic hilum in living donors.
Liver Transpl
January 2023
Department of Surgery , Keio University School of Medicine, Tokyo , Japan.
Biliary complications after hepatectomy in living donors have yet to be eradicated. We hypothesized that a standardized upfront Glissonean approach and liver hanging maneuver (GH) would prevent mechanical and thermal injuries to the hilar plate of the remnant liver by determining the point of bile duct division and the final destination of hepatectomy preceding liver parenchymal transection (safety) and facilitate liver transection deep within the parenchyma and allow maximum length of hilar structures (rationality). GH was implemented in 2016 and its incidence of bile leakage was retrospectively compared against the conventional technique.
View Article and Find Full Text PDFLaparoscopic Left Hemihepatectomy Using the Hilar Plate-First Approach (with Video).
World J Surg
October 2022
Center for Liver and Pancreatobiliary Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandonggu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
Background: Effective inflow and outflow control of the liver is essential for a safe hepatectomy. Detachment of the hilar plate is a fundamental technique in the Glissonean approach. The hilar plate is situated near the middle hepatic vein, which runs in the midplane of the liver, and serves as a landmark during hemihepatectomy.
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