Author/Editor     Trotovšek, Blaž; Belghiti, Jacques; Gadžijev, Eldar M; Ravnik, Dean; Hribernik, Marija
Title     Anatomical basis of the liver hanging maneuver
Type     članek
Source     Hepatogastroenterology
Vol. and No.     Letnik 52
Publication year     2005
Volume     str. 728-30
Language     eng
Abstract     Background/Aims: The anterior approach to right hepatectomy using the liver hanging maneuver without liver mobilization claims to be anatomically evaluated. During this procedure a 4 to 6-cm blind dissection between the inferior vena cava and the liver is performed. Short subhepatic veins, entering the inferior vena cava could be torn and a hemorrhage, difficult to control, could occur. Methodology: On 100 corrosive casts of livers the anterior surface of the inferior vena cava was studied to evaluate the position, diameter and draining area of short subhepatic veins and inferior right hepatic vein. The width of the narrowest point on the planned route of blind dissection was determined. Results: The average value of the narrowest point on the planned route of blind dissection was 8.7±2.3mm (range 2-15mm). The ideal angle of dissection being 0° was found in 93% of cases. In 7% we found the angle of 5° toward the right border of inferior vena cava to be the better choice. Conclusions: Our results show that liver hanging maneuver is a safe procedure. With the dissection in the proposed route the risk of disrupting short subhepatic veins is low (7%).
Descriptors     HEPATIC VEINS
HEPATECTOMY
VENA CAVA, INFERIOR
IATROGENIC DISEASE
DISSECTION
CORROSION CASTING