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Updated: Jul 12, 2025
Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Multiplanar CT reconstructions allow optimization of the laparoscopic surgical approach for liver lesions
Fabien Werey1, Kevin Allart1, Jeanne Dembinski1,2
1Department of Digestive Surgery, Amiens University Medical Center and Jules Verne University of Picardie, 1 Rue du Professeur Christian Cabrol, F-80054, Amiens Cedex, France.
Purpose:
Resection of hepatic lesions can be difficult and requires careful analysis of pre-operative imaging. The aim of this study is to highlight the use of multiplanar CT reconstruction in liver surgery, which helps to anticipate intra-operative technical difficulties.
Methods:
We retrospectively selected the imaging of several patients managed for liver lesions in specific locations: liver dome (IVa, VIII), the left lobe (intra-parenchymal, left edge), and the antero-inferior edge of segment VI. The IWATE classification was used to grade the difficulty of these resections.
Results:
Multiplanar analysis has made it possible to change the level of difficulty of liver resection and to anticipate intra-operative difficulties. Frontal and/or sagittal section in addition to axial sections analysis increased the IWATE score.
Conclusion:
Multi-planar reconstruction must be a tool used by the liver surgeon pre-operatively in order to limit intra-operative complications.