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Related Experiment Video

Updated: Jun 12, 2026

Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique
03:48

Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique

Published on: October 6, 2023

Extra-Glissonian approach in liver resection.

Marco Giordano1, Santiago Lopez-Ben, Antoni Codina-Barreras

  • 1Hepato-Biliary Surgery Unit, Catholic University of the Sacred Heart, Rome, Italy.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
|May 25, 2010
PubMed
Summary

The extraglissonian approach is effective in liver surgery for both major resections and minor hepatectomies. This technique offers benefits by preventing ischemia and improving hemodynamic stability during selective clamping procedures.

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Techniques
  • Anatomical Approaches

Background:

  • The extraglissonian approach to hilar structures is analyzed in liver resections.
  • This study examines its application in pedicle transection (major resections) and selective clamping (minor hepatectomies).

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the extraglissonian approach in liver surgery.
  • To compare its use in major liver resections versus minor hepatectomies.

Main Methods:

  • Retrospective analysis of 89 major liver resections and 103 minor liver resections.
  • Extraglissonian approach with stapler transection used in 61% of major resections.
  • Extraglissonian approach with selective clamping used in 26% of minor resections.

Related Experiment Videos

Last Updated: Jun 12, 2026

Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique
03:48

Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique

Published on: October 6, 2023

Main Results:

  • In major resections, extraglissonian approach showed similar operative time, blood loss, transfusion rates, and mortality compared to standard dissection.
  • In minor resections, operative time, blood loss, and transfusion rates were comparable between Pringle maneuver and selective clamping.
  • Selective clamping in minor resections resulted in significantly longer pedicle clamping duration (44 vs. 26 minutes).

Conclusions:

  • The extraglissonian approach is a valuable technique in liver surgery.
  • Selective clamping using this approach prevents hemiliver ischemia and maintains hemodynamic stability.
  • This method reduces splanchnic stasis and the need for fluid replacement.