Laparoscopic Hepatic Resection Using Extracorporeal Pringle Maneuver

2018 ◽  
Vol 28 (4) ◽  
pp. 452-458 ◽  
Author(s):  
Yoshihiro Inoue ◽  
Yusuke Suzuki ◽  
Kensuke Fujii ◽  
Nao Kawaguchi ◽  
Masatsugu Ishii ◽  
...  
Keyword(s):  
Hepatic Resection ◽  
Pringle Maneuver ◽  
Laparoscopic Hepatic Resection

scholarly journals Laparoscopic hepatic resection

2020 ◽  
Vol 4 ◽  
pp. 18-18
Author(s):  
David Brough ◽  
Nicholas O’Rourke
Keyword(s):  
Hepatic Resection ◽  
Laparoscopic Hepatic Resection

Outcomes of Pure Laparoscopic versus Open Hepatic Resection for Hepatocellular Carcinoma in Cirrhotic Patients: A Case-Control Study with Propensity Score Matching

2015 ◽  
Vol 55 (4) ◽  
pp. 291-301 ◽  
Author(s):  
Shogo Tanaka ◽  
Shigekazu Takemura ◽  
Hiroji Shinkawa ◽  
Takayoshi Nishioka ◽  
Genya Hamano ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Blood Loss ◽  
Hepatic Resection ◽  
Propensity Score Matching ◽  
Activity Index ◽  
Disease Free Survival ◽  
Intraoperative Blood Loss ◽  
Laparoscopic Hepatic Resection ◽  
Cirrhotic Patients

Background/Purpose: Laparoscopic hepatic resection (LH) for hepatocellular carcinoma (HCC) has gradually gained ground as a safe and minimally invasive treatment, although LH for cirrhotic patients remains challenging. Methods: Between January 2007 and August 2014, 28 and 57 patients with histologically proven cirrhosis (histological activity index, fibrosis score 4) underwent pure LH and open hepatic resection (OH; less than segmentectomy), respectively, for peripheral HCC ≤5 cm. To correct the difference in clinicopathological factors, including difficulty scores, between the two groups, propensity score matching was used at a 1:1 ratio, which resulted in a comparison of 20 patients per group. We compared the short- and long-term outcomes of LH and OH to investigate the efficacy of LH. Results: Clinicopathological variables, including difficulty scores, were well balanced between the two groups. The incidence of complications and mean intraoperative blood loss were lower in the LH group than the OH group (0 vs. 45% and 180 vs. 440 ml, p = 0.001 and 0.04, respectively). The 3-year disease-free survival rate was 42% in the LH group and 30% in the OH group (p = 0.533), whereas the 5-year overall survival rates were 46 and 60%, respectively (p = 0.606). Conclusions: LH is a safe and effective treatment option for cirrhotic patients with HCC in terms of intraoperative blood loss and morbidity.

Laparoscopic hepatic resection for hepatocellular carcinoma

1995 ◽  
Vol 9 (12) ◽  
Author(s):  
M. Hashizume ◽  
K. Takenaka ◽  
K. Yanaga ◽  
M. Ohta ◽  
K. Kajiyama ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Resection ◽  
Laparoscopic Hepatic Resection

scholarly journals Hepatic resection using ultrasonic surgical aspirator

2017 ◽  
Vol 9 (2) ◽  
pp. 175-183
Author(s):  
Suvit Sriussadaporn ◽  
Sukanya Sriussadaporn ◽  
Rattaplee Pak-art ◽  
Kritaya Kritayakirana ◽  
Supparerk Prichayudh ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Hepatic Resection ◽  
Operative Time ◽  
Hepatic Duct ◽  
Surgical Techniques ◽  
Pringle Maneuver ◽  
Parenchymal Transection ◽  
Right Hepatectomy ◽  
Ultrasonic Surgical Aspirator

Abstract Background Hepatic resections conducted for malignant tumors can be difficult because of the need to create cancer-free margins. Objectives To examine the outcome of hepatic resections after the introduction of a Cavitron Ultrasonic Surgical Aspirator (CUSA). Methods A retrospective study of patients who underwent hepatic resection by a single surgeon between April 1999 to March 2013. Results We included 101 patients with 104 hepatectomies. Most hepatic parenchymal transections were performed using a CUSA under intermittent hepatic inflow occlusion (Pringle maneuver). Thirty-five patients underwent a right hepatectomy, 11 a left hepatectomy, 6 a right hepatectomy and segment I resection, 6 a right lobectomy, and 46 underwent segmentectomies, wedge resections, or other types of hepatic resections. Biliary-enteric reconstruction with a Roux-en-Y limb of the jejunum to a hepatic duct of the hepatic remnant was performed in 28 patients. Operative time was 90–720 min (median 300 min, mean 327 ± 149 min). Operative blood transfusion was 0–17 units (median 3 units, mean 3.9 ± 3.6 units). Twenty-one hepatectomies were conducted without blood transfusion. Thirty-four postoperative complications occurred in 30 patients with a 9% reoperation rate. Perioperative mortality was 6%. Age, operative time, operative blood transfusion, reoperation, and complications were significantly associated with mortality. Conclusion Careful preoperative diagnosis and evaluation of patients, faultless surgical techniques, and excellent postoperative care are important to avoid potentially serious postoperative complications and mortality. The CUSA is an effective assisting device during hepatic parenchymal transection with a concomitant Pringle maneuver, apparently reducing operative blood loss.

A Prospective Evaluation of Ultrasonic Dissector plus Harmonic Scalpel in Liver Resection

2007 ◽  
Vol 73 (3) ◽  
pp. 256-260 ◽  
Author(s):  
Marcella Arru ◽  
Carlo PulitanÒ ◽  
Luca Aldrighetti ◽  
Marco Catena ◽  
Renato Finazzi ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Resection ◽  
Surgical Complications ◽  
Harmonic Scalpel ◽  
Electronic Devices ◽  
Operating Time ◽  
Liver Parenchyma ◽  
Pringle Maneuver ◽  
Postoperative Hemorrhage ◽  
Ultrasonic Dissector

Several techniques have been described for safe dissection of the liver parenchyma. The aim of this study was to evaluate the feasibility and effectiveness of combining two different electronic devices, the ultrasonic dissector and the harmonic scalpel, during hepatic resection. One hundred consecutive patients who underwent liver resection between January and December 2004 were enclosed in the study. Patients requiring concomitant colic resection or biliary-enteric anastomosis were excluded from the study. Operative variables (type of procedure, operating time, Pringle time, blood losses, transfusions, and histological tumor exposure at the transection surface), hospital stay, and complications were recorded. The extent of hepatic resection was a minor resection in 31 and major in 69 cases. Median blood loss was 500 mL (range, 100–2000 mL) and the Pringle maneuver was used in 58 patients. Median operative time was 367 minutes (range, 150–660 minutes). Hepatic resection was performed in 32 cirrhotic livers. Surgical complications included one postoperative hemorrhage and two bile leaks. The overall morbidity and mortality rate was 14 and 1 per cent, respectively. In conclusion, the combined use of these electronic devices allows liver resection to be safely performed, even in cirrhotic patients, with the advantage of reducing surgical complications. A prospective randomized trial is needed to clarify the clinical benefits of liver resections performed combining these two devices.

Laparoscopic hepatic resection

2006 ◽  
Vol 20 (5) ◽  
pp. 787-790 ◽  
Author(s):  
G. Borzellino ◽  
A. Ruzzenente ◽  
A.- M. Minicozzi ◽  
F. Giovinazzo ◽  
C. Pedrazzani ◽  
...  
Keyword(s):  
Hepatic Resection ◽  
Laparoscopic Hepatic Resection
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