Laparoscopic Parenchymal-Sparing Liver Resections Using the Intrahepatic Glissonian Approach

Annals of Surgical Oncology
Marcel Autran C MachadoFabio F Makdissi

Abstract

One of the main criticisms of laparoscopic liver resection is that it is difficult, or not possible, to perform liver-sparing resections. Our aim was to present short videos where the intrahepatic Glissonian approach was used to perform anatomical liver segmental resections, instead of a larger operation, to avoid unnecessary sacrifice of the liver parenchyma. We selected six types of anatomical liver resections to exemplify the use of the intrahepatic Glissonian approach to perform segment-oriented liver resections. These types of hepatectomies were used as an alternative to right or left hepatectomy, or as an alternative to extended liver resections. The intrahepatic Glissonian approach was feasible in all cases. The use of anatomical landmarks previously described was essential to reach and control the Glissonian pedicles. Among the liver-sparing resections, we were able to perform right anterior (S5 + S8) and posterior (S6 + S7) sectionectomies, resection of segments 2, 3, and 4, and mesohepatectomy (S4 + S5 + S8). No patient presented postoperative liver failure. Laparoscopic liver-sparing resections are feasible and may be a good alternative to hemihepatectomies or extended liver resections. The use of the intrahepatic Gl...Continue Reading

References

Jul 11, 2008·American Journal of Surgery·Marcel Autran C MachadoMarcel C C Machado
Mar 20, 2009·Surgical Endoscopy·M A C MachadoM C C Machado
Jul 16, 2015·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Rodrigo Cañada Trofo SurjanMarcel Autran Cesar Machado
Mar 10, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Kimberly M Brown, David A Geller

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Citations

Nov 5, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Demetrios MorisTimothy M Pawlik
Nov 22, 2018·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Fabien ClipetJean-Marc Regimbeau
Mar 12, 2019·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Shuai XiangWan-Guang Zhang
Feb 3, 2021·Journal of Hepato-biliary-pancreatic Sciences·Mamoru MorimotoUNKNOWN Study group of Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic surgery (PAM-HBP surgery)

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