Techniques for liver parenchymal transection in liver resection

Gurusamy, Kurinchi Selvan; Pamecha, Viniyendra; Sharma, Dheeraj; Davidson, BR

doi:10.1002/14651858.cd006880

Cited by 28 publications

(32 citation statements)

References 31 publications

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“…In our study, only eight patients (1.7 %) underwent a radiological intervention with minimal perioperative mortality (0.4 % at 30 days). Certainly, such good results may be related to the transection methods and to cut surface care, which is mainly based on the meticulous check for a minimum fixed time of 50 min to rule out major bleeding or a bile leak [32][33][34][35]. However, considering the tendency of bile leaks to spontaneous heal [36], drain maintenance up to POD 7 allows focusing on those patients, who deserve clinical monitoring and drain maintenance, to minimize the rate of unrecognized collections and PD placement.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Bile Leaks After Hepatectomy: Results of a Prospective Analysis of 475 Hepatectomies

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Bile Leaks After Hepatectomy: Results of a Prospective Analysis of 475 Hepatectomies

et al. 2015

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“…To date, the Kelly clamp crushing technique coupled to intermittent pedicle clamping is the most efficient method in terms of resection time, blood loss, and blood transfusion frequency and has proved to be also the most costefficient device [28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments

et al. 2011

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“…[26][27][28] e) Liver transection techniques depend on the availability, experience and preference of the operating surgeon; Cochrane reviews have suggested that Kellyclasie is the quickest and most cost-efficient, although atypical resections may benefit from CUSA (cavitary ultrasound suction aspirator). 29,30 f) Anterior approach may prove advantageous in patients with large tumors, where mobilization off the cava may involve traction on the tumor with the possibility of tumor rupture, bleeding and dissemination of tumor cells due to handling of the tumor. 31,32 This may further be facilitated by the hanging maneuver where a catheter is passed by blunt dissection just anterior to the inferior vena cava and between the right and middle hepatic veins.…”

Section: Principles Of Surgical Resectionmentioning

confidence: 99%

Resection for Hepatocellular Carcinoma

Ramesh

2014

Journal of Clinical and Experimental Hepatology

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Hepatocellular Carcinoma (HCC) continues to present major challenges in management, which is further complicated by the presence of associated chronic liver disease. Key issues in surgical resection of HCC include the site, size, and number of lesions, the severity of the chronic liver disease, and the size of the functional liver remnant. De novo HCC in the absence of chronic liver disease can be treated by major liver resection with little risk of postoperative liver failure. Liver resection can also be used a bridge to liver transplantation as it affords the possibility of determining the pathologic grade of the tumortumor and its invasiveness, and thereby the prognosis. This review summarizes the current treatment approaches to surgical resection for HCC. ( J CLIN EXP HEPATOL 2014;4:S90-S96) R ecommendations for treatment of HCC should be based on randomized controlled trials or meta analyses, rather than by non randomized clinical trials or observational studies. However, there is a paucity of robust evidence regarding the treatment of HCC. Interventions have not been thoroughly tested against each other. Hence the strength of evidence for most interventions is less than desirable. Therefore treatment decisions must be taken by a multi-disciplinary group which comprises hepatologists, surgeons, radiologists, interventional radiologists, pathologists, nurses, palliative care physicians, patient education specialists, and pharmacists. Treatment decisions must be made in a tumortumor board meeting.In India, the problem is compounded by the fact that the country is large, and there is considerable variation in the expertise and technology available for the treatment of HCC. It is inconceivable that HCC shall be treated only in a few centers with state-of-the art services. While treatment guidelines must therefore be treated with caution, the right of every patient with HCC to standardized care has placed a huge burden on healthcare systems to deliver for these patients. Although prevention of HBV related cancer is still the priority, yet, treatment of the established HCC is also necessity.The radical treatment options are: No randomized data is available at this time comparing these three approaches. Hence existing guidelines are dependent on cure rates with these treatment approaches. HEPATOCELLULAR CARCINOMA IN THE ABSENCE OF LIVER DISEASEHCC in background of healthy liver (without cirrhosis or chronic hepatitis) may occur occasionally.1 There are two types: a) the classical sporadic variety, and b) the fibrolamellar variant. The fibrolamellar variant is characteristic in the female preponderance, absence of AFP elevation, and in the presence of lymph node involvement. These tumors present only as mass lesions and at an advanced stage. Despite this advanced stage at presentation, resection can be done as the healthy liver has a normal ability to regenerate. Survival following resection is over 50% at 5 years. 2 HEPATOCELLULAR CARCINOMA IN THE PRESENCE OF LIVER DISEASEResection for HCC has several advantages: ...

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Techniques for liver parenchymal transection in liver resection

Cited by 28 publications

References 31 publications

Diagnosis and Management of Bile Leaks After Hepatectomy: Results of a Prospective Analysis of 475 Hepatectomies

Diagnosis and Management of Bile Leaks After Hepatectomy: Results of a Prospective Analysis of 475 Hepatectomies

Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments

Resection for Hepatocellular Carcinoma

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