PMID: 2487059Apr 1, 1989Paper

A new simplified method of selective exposure of hepatic pedicles for controlled hepatectomies

HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery
E I Galperin, S R Karagiulian

Abstract

Our experience of 90 hepatectomies (HE) and examinations of 64 cadaver livers resulted in the elaboration of a simplified technique for the exposure of hepatic pedicles (HP) and the rapid selective ligation without significant normothermal ischemia of the retained parts of the liver. The method comprises 4 consecutive steps: 1) a superficial T-shaped incision of Glisson's capsule at the site of HP projection on the liver's inferior surface, 2) introduction of the surgeon's forefinger into the liver parenchyma, controlled by clamping the hepatoduodenal ligament, the fingertip finding a tubular structure well distinguished by its smooth elastic surface from the friable parenchyma and bending the finger to hook the pedicle, 3) drawing the hooked pedicle downwards through the slit in the capsule and temporarily clamping it, while releasing the hepatoduodenal ligament so as to restore blood supply to the retained parts of the liver, 4) checking for correct ligature position on the HP before its final ligation by matching the actual ischemic area with the intended line of resection and moving the clamp proximally or distally along the exposed pedicle for the release or clamping of lateral branches as necessary. Whereupon resection ca...Continue Reading

Citations

Mar 27, 2012·Surgical Endoscopy·Fernando RotellarNicolás Pedano
Apr 14, 2005·Annals of Surgical Oncology·Ramaz E MetreveliNicholas J Petrelli
Sep 30, 2014·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Huanwei ChenWan Yee Lau
Apr 1, 1993·The Australian and New Zealand Journal of Surgery·J M Little
Feb 1, 2013·Clinical Journal of Gastroenterology·Tadashi TsukamotoShoji Kubo
Oct 23, 2009·Advances in Surgery·Michael R Marvin, Joseph F Buell
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Mar 5, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Fei LiuBo Li
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Jan 15, 2020·Surgical Endoscopy·Takao IdeHirokazu Noshiro

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