Anterior approach for right hepatectomy using the 5-steps stapling technique: A preliminary study

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Minimally Invasive Techniques

Background:

• Right hepatectomy is a critical procedure where controlling blood loss during parenchymal transection is vital.
• Excessive bleeding and transfusion increase postoperative risks and negatively impact long-term outcomes.
• The liver hanging maneuver facilitates anterior approach right hepatectomy.

Purpose of the Study:

• To introduce and evaluate a novel 5-step stapling technique for right hepatectomy.
• To assess the efficacy of this technique in reducing intraoperative blood loss.
• To report preliminary outcomes including operative time and complications.

Main Methods:

• A 5-step stapling technique was developed to minimize blood loss during right hepatectomy.
• The anterior approach with the liver hanging maneuver was employed.
• A retrospective study of 11 consecutive patients undergoing elective right hepatectomy from January 2014 to June 2015 was conducted.

Main Results:

• The study included 11 patients with hepatitis B-related hepatocellular carcinoma (HCC) and cirrhosis.
• Mean blood loss was 227.3 ml, with a mean parenchymal transection time of 40.0 minutes and operation time of 261.8 minutes.
• No postoperative bleeding or bile leaks were observed, and there was no 90-day mortality.

Conclusions:

• The 5-step stapling technique for right hepatectomy using the liver hanging maneuver is effective.
• The technique leads to minimal intraoperative blood loss and shorter operation times.
• Preliminary results indicate a safe procedure with no major complications or mortality.