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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Two-stage hepatectomy: tape it and hang it, while you can
Olivier Scatton1, Georgios Katsanos, Olivier Soubrane
1Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie, Paris Cedex 12, France. olivier.scatton@sat.aphp.fr
World Journal of Surgery
|March 10, 2012
Summary
This study introduces a surgical technique to simplify two-stage hepatectomy for liver tumors. By taping major vessels and using a hanging maneuver in the first stage, surgeons can more easily perform the second stage, improving patient outcomes.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Colorectal Cancer Metastasis
Background:
- Two-stage hepatectomy is a standard treatment for multifocal bilobar liver lesions, particularly colorectal cancer metastases.
- Managing complex liver resections requires innovative surgical approaches.
Purpose of the Study:
- To describe a novel technique for facilitating second-stage hepatectomy.
- To simplify the surgical management of multifocal bilobar hepatic lesions.
Main Methods:
- The technique involves taping major vascular structures (right hepatic artery, right portal branch) and a hanging maneuver during the first-stage hepatectomy.
- These aids are left in situ until the second-stage procedure.
Main Results:
- Vascular tapes and the hanging loop significantly aid dissection, vascular control, and orientation during the second stage, eliminating the need for liver mobilization.
- Six patients underwent the procedure with no vascular complications or infections related to the tapes; one patient experienced a manageable biliary leak.
Conclusions:
- This surgical technique, in use since 2009, has proven effective in facilitating second-stage hepatectomy.
- The described method offers a valuable approach to managing complex liver resections.
