A modified liver-hanging maneuver focusing on the ligamentum venosum for left hepatic lobectomy |
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Authors: | Satoru Imura Mitsuo Shimada Tohru Utsunomiya Yuji Morine Tetsuya Ikemoto Hiroki Mori Jun Hanaoka Hiroki Ishibashi Hidenori Miyake |
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Institution: | Department of Surgery, Institute of Health Biosciences, The University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan. |
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Abstract: | Purpose The liver-hanging maneuver (LHM) is a useful technique in major hepatectomy. We made modifications to this technique with special reference to the ligamentum venosum for performing a left hepatectomy (LH). The aim of this study was to clarify the usefulness of our new technique. Methods Between August 2007 and May 2009, five patients underwent LH using our modified LHM and 12 patients underwent LH using a conventional procedure. The two groups were compared in terms of the patient characteristics, preoperative hepatic functions, surgical records, and outcomes. Results The characteristics and preoperative hepatic function tests were similar between the modified LHM and non-LHM groups. Intraoperative blood loss was significantly reduced in the modified LHM group compared with the non-LHM group (193?±?133 vs. 375?±?167?ml, P?0.05). The lengths of the operations and time required to perform a parenchymal transection did not differ significantly between the two groups (duration of operations 273?±?37 vs. 337?±?70?min; transection times 29?±?10 vs. 28?±?13?min). The postoperative complications and hospital stays did not differ significantly between the two groups. Conclusion Our modified LHM can reduce the intraoperative blood loss during LH, and our results have shown the usefulness of this modified technique for LH. |
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