AIM： To review 11 patients with parasitic cysts of the liver, who were treated by hepatic Iobectomy using the liver hanging maneuver （LHM）.METHODS： Between January 2003 and June 2006, we retrospectively analyzed p...AIM： To review 11 patients with parasitic cysts of the liver, who were treated by hepatic Iobectomy using the liver hanging maneuver （LHM）.METHODS： Between January 2003 and June 2006, we retrospectively analyzed patients who underwent surgical treatment due to parasitic cysts of the liver, at the Ege University School of Medicine, Department of General Surgery. Of these, the patients who underwent hepatic lobectomy using the LHM were reviewed and evaluated for surgical treatment outcome.RESULTS： Over a three-year period, there were 102 patients who underwent surgical treatment for parasitic cysts of the liver. Of these, 11 （10%） patients with parasitic cysts of the liver underwent hepatic Iobectomy using the LHM. Presenting symptoms were abdominal pain, dyspepsia, and cholangitis. Cyst locations were as follows： right lobe filled with cyst, 7 （63%）; segmental location, 2 （18%）; and multiple locations, 2 patients （18%）. All patients underwent hepatic Iobectomy with an anterior approach using the LHM. The intraoperative blood transfusion requirement was one unit for 3 patients and two units for one patient. Postoperative complications included pulmonary atelectasy （2, 18%） and pleural effusion （2, 18%）. No significant morbidity or mortality was observed.CONCLUSION： We concluded that hepatic Iobectomy using the LHM should be considered, not only for hepatic tumors or donor hepatectomy, but also to treat parasitic cysts of the liver.展开更多
AIM： To evaluate the efficacy of the two-surgeon technique with the liver hanging maneuver （LHM） for hepatectomies in pediatric patients with hepatoblastoma. METHODS： Three pediatric patients with hepatoblastoma w...AIM： To evaluate the efficacy of the two-surgeon technique with the liver hanging maneuver （LHM） for hepatectomies in pediatric patients with hepatoblastoma. METHODS： Three pediatric patients with hepatoblastoma were enrolled in this study. Two underwent right hemi-hepatectomies and one underwent a left hemihepatectomy using the two-surgeon technique by means of saline-linked electric cautery （SLC） and the Cavitron Ultrasonic Surgical Aspirator （CUSA; Valleylab, Boulder, CO） and the LHM. RESULTS： The mean operative time during the parenchymal transections was 50 rain and the mean blood loss was 235 g. There was no bile leakage from the cut surface after surgery. No macroscopic or microscopic-positive margins were observed in the hepatic transections. CONCLUSION： The two-surgeon technique using SLC and CUSA with the LHM is applicable to even pediatric patients with hepatoblastoma.展开更多
Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far ...Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far no report has detailed how to quickly and easily establish RT for laparoscopic LHM in LRH, nor has employment of the Goldfinger dissector to create a total RT been reported. This study＇s aim was to evaluate the safety and feasibility of establishing RT for laparoscopic LHM using the Goldfinger dissector in LRH. Methods： Between March 2015 and July 2015, five consecutive patients underwent LRH via the caudal approach with laparoscopic LHM. A five-step strategy using the Goldfinger dissector to establish RT for laparoscopic LHM was adopted. Perioperative data were analyzed. Results： The median age of patients was 58 （range, 51-65） years. Surgery was performed for one intrahepatic lithiasis and four hepatocellular carcinomas with a median size of 90 （40-150） mm. The median operative time was 320 （282-358） min with a median blood loss of 200 （200-600） ml. Laparoscopic LHM was achieved in a median of 31 （21-62） min, and the median postoperative hospital stay was 14 （9-16） d. No transfusion or conversion was required, and no severe liver-related morbidity or death was observed. Conclusions： The Goldfinger dissector is a useful instrument for the establishment of RT. A five-step strategy using the Goldfinger dissector can quickly and easily facilitate an RT for a laparoscopic LHM in LRH.展开更多
文摘AIM： To review 11 patients with parasitic cysts of the liver, who were treated by hepatic Iobectomy using the liver hanging maneuver （LHM）.METHODS： Between January 2003 and June 2006, we retrospectively analyzed patients who underwent surgical treatment due to parasitic cysts of the liver, at the Ege University School of Medicine, Department of General Surgery. Of these, the patients who underwent hepatic lobectomy using the LHM were reviewed and evaluated for surgical treatment outcome.RESULTS： Over a three-year period, there were 102 patients who underwent surgical treatment for parasitic cysts of the liver. Of these, 11 （10%） patients with parasitic cysts of the liver underwent hepatic Iobectomy using the LHM. Presenting symptoms were abdominal pain, dyspepsia, and cholangitis. Cyst locations were as follows： right lobe filled with cyst, 7 （63%）; segmental location, 2 （18%）; and multiple locations, 2 patients （18%）. All patients underwent hepatic Iobectomy with an anterior approach using the LHM. The intraoperative blood transfusion requirement was one unit for 3 patients and two units for one patient. Postoperative complications included pulmonary atelectasy （2, 18%） and pleural effusion （2, 18%）. No significant morbidity or mortality was observed.CONCLUSION： We concluded that hepatic Iobectomy using the LHM should be considered, not only for hepatic tumors or donor hepatectomy, but also to treat parasitic cysts of the liver.
文摘AIM： To evaluate the efficacy of the two-surgeon technique with the liver hanging maneuver （LHM） for hepatectomies in pediatric patients with hepatoblastoma. METHODS： Three pediatric patients with hepatoblastoma were enrolled in this study. Two underwent right hemi-hepatectomies and one underwent a left hemihepatectomy using the two-surgeon technique by means of saline-linked electric cautery （SLC） and the Cavitron Ultrasonic Surgical Aspirator （CUSA; Valleylab, Boulder, CO） and the LHM. RESULTS： The mean operative time during the parenchymal transections was 50 rain and the mean blood loss was 235 g. There was no bile leakage from the cut surface after surgery. No macroscopic or microscopic-positive margins were observed in the hepatic transections. CONCLUSION： The two-surgeon technique using SLC and CUSA with the LHM is applicable to even pediatric patients with hepatoblastoma.
基金Project supported by the General Research Project of Medicine and Science of Zhejiang Province(Nos.2014KYB119 and 2015KYB221),China
文摘Objective： The liver hanging maneuver （LHM） is rarely applied in laparoscopic right hepatectomy （LRH） because of the difficulty encountered in retrohepatic tunnel （RT） dissection and tape positioning. Thus far no report has detailed how to quickly and easily establish RT for laparoscopic LHM in LRH, nor has employment of the Goldfinger dissector to create a total RT been reported. This study＇s aim was to evaluate the safety and feasibility of establishing RT for laparoscopic LHM using the Goldfinger dissector in LRH. Methods： Between March 2015 and July 2015, five consecutive patients underwent LRH via the caudal approach with laparoscopic LHM. A five-step strategy using the Goldfinger dissector to establish RT for laparoscopic LHM was adopted. Perioperative data were analyzed. Results： The median age of patients was 58 （range, 51-65） years. Surgery was performed for one intrahepatic lithiasis and four hepatocellular carcinomas with a median size of 90 （40-150） mm. The median operative time was 320 （282-358） min with a median blood loss of 200 （200-600） ml. Laparoscopic LHM was achieved in a median of 31 （21-62） min, and the median postoperative hospital stay was 14 （9-16） d. No transfusion or conversion was required, and no severe liver-related morbidity or death was observed. Conclusions： The Goldfinger dissector is a useful instrument for the establishment of RT. A five-step strategy using the Goldfinger dissector can quickly and easily facilitate an RT for a laparoscopic LHM in LRH.
