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Updated: Apr 27, 2026
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Indications, limitations and maneuvers to enable extended hepatectomy: current trends
Dimitrios Dimitroulis1, Petros Tsaparas1, Serena Valsami1
1Dimitrios Dimitroulis, Petros Tsaparas, Dimitrios Mantas, Eleftherios Spartalis, Charalampos Markakis, Gregory Kouraklis, Second Department of Propedeutic Surgery, Athens University Medical School, "Laiko" Hospital, 11527 Athens, Greece.
Extended liver resections offer curative treatment for liver tumors. Techniques like portal vein embolization and in situ liver transection safely increase remnant liver volume, expanding surgical candidacy.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Liver Transplantation
Background:
- Liver tumors, both primary and metastatic, necessitate surgical resection for curative intent.
- Limitations in patient selection often preclude extended hepatic resections.
- Novel strategies are required to expand the pool of candidates for curative liver surgery.
Purpose of the Study:
- To review indications and limitations for extended hepatic resections.
- To evaluate methods for increasing future remnant liver volume.
- To assess the safety and efficacy of advanced liver resection techniques.
Main Methods:
- Comprehensive literature review on extended hepatectomy indications and techniques.
- Evaluation of portal vein ligation, portal vein embolization, and two-stage hepatectomy.
- Analysis of in situ liver transection as a novel approach.
Main Results:
- Extended hepatectomies are oncologically indicated for liver malignancies.
- Methods to augment remnant liver volume are safe and effective.
- In situ liver transection is a promising, revolutionary technique for complex resections.
Conclusions:
- Extended liver resections are crucial for oncological outcomes.
- Techniques to increase remnant liver volume enhance surgical feasibility.
- Further research on in situ liver transection is needed to confirm long-term oncological benefits.
