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Updated: Jul 15, 2026
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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
A new technique for resecting 'unresectable' liver tumors
R A Superina1, D Bambini, R M Filler
1Children's Memorial Medical Center, Chicago, IL 60614, USA.
Journal of Pediatric Surgery
|September 22, 2000
Summary
This study introduces an extended atypical left hepatectomy for liver tumors near major hepatic veins. The technique is successful when retrohepatic veins adequately drain blood, offering a new option for previously unresectable liver tumors.
Area of Science:
- Hepatobiliary surgery
- Pediatric oncology
- Surgical oncology
Background:
- Liver tumors adjacent to major hepatic veins are often deemed unresectable.
- This report details an extended atypical left hepatectomy for such challenging cases.
Observation:
- Three pediatric patients with tumors surrounding hepatic veins were evaluated.
- The procedure involves temporary occlusion of hepatic vasculature, relying on retrohepatic veins for perfusion.
- Successful resection requires the liver to remain soft and well-perfused.
Findings:
- The extended atypical left hepatectomy was successful in two out of three children.
- One patient experienced a bile leak that resolved spontaneously.
- Transient elevations in bilirubin, transaminases, and prothrombin time were observed post-surgery.
- The third patient required abandonment of the procedure due to liver mottling and tension.
Implications:
- The success of this hepatectomy hinges on adequate collateral drainage via retrohepatic veins.
- Close intraoperative monitoring for liver turgor is crucial.
- Procedure abandonment and consideration for liver transplantation are necessary if the liver becomes tense and mottled.
