Skip to main content
Log in

Safe and feasible extrahepatic Glissonean access in laparoscopic anatomical liver resection

  • Technique
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Although recent technological developments and improved endoscopic procedures have further spread the application of laparoscopic liver resection, laparoscopic anatomical liver resection still presents major technical difficulties, such as pedicle control.

Methods

Subjects comprised 27 patients who underwent laparoscopic anatomical liver resection using an extrahepatic Glissonean pedicle transaction between August 2005 and February 2010.

Results

A total of 61 Glissonean pedicles could be encircled en bloc extrahepatically, as planned. No serious complications, including major bleeding or injury of the portal triad, were encountered during procedures.

Conclusions

Extrahepatic Glissonean access seems to be feasible and safe for laparoscopic anatomical resection of the liver.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Kaneko H, Takagi S, Shiba T (1996) Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series. Surgery 120:468–475

    Article  PubMed  CAS  Google Scholar 

  2. Shimada M, Hashizume M, Maehara S, Tsujita E, Rikimaru T, Yamashita Y, Tanaka S, Adachi E, Sugimachi K (2001) Laparoscopic hepatectomy for hepatocellular carcinoma. Surg Endosc 15:541–544

    Article  PubMed  CAS  Google Scholar 

  3. Wakabayashi G (2009) Laparoscopic liver resection: how far can we go? J Hepatobiliary Pancreat Surg 16:403–404

    Article  PubMed  Google Scholar 

  4. Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS, World Consensus Conference on Laparoscopic Surgery (2009) The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg 250:825–380

    Google Scholar 

  5. O’Rourke N, Fielding G (2004) Laparoscopic right hepatectomy: surgical technique. J Gastrointest Surg 8:213–216

    Article  PubMed  Google Scholar 

  6. Dagher I, Di Giuro G, Lainas P, Franco D (2009) Laparoscopic right hepatectomy with selective vascular exclusion. J Gastrointest Surg 13:148–149

    Article  PubMed  Google Scholar 

  7. Han HS, Cho JY, Yoon YS (2009) Techniques for performing laparoscopic liver resection in various hepatic locations. J Hepatobiliary Pancreat Surg 16:427–432

    Article  PubMed  Google Scholar 

  8. Gayet B, Cavaliere D, Vibert E, Perniceni T, Levard H, Denet C, Christidis C, Blain A, Mal F (2007) Totally laparoscopic right hepatectomy. Am J Surg 194:685–689

    Article  PubMed  Google Scholar 

  9. Takasaki K, Kobayashi S, Tanaka S, Saito A, Yamamoto M, Hanyu F (1990) Highly anatomically systematized hepatic resection with Glissonean sheath code transection at the hepatic hilus. Int Surg 75:73–77

    PubMed  CAS  Google Scholar 

  10. Takasaki K (1998) Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary Pancreat Surg 5:286–291

    Article  PubMed  CAS  Google Scholar 

  11. Cho A, Asano T, Yamamoto H, Nagata M, Takiguchi N, Kainuma O, Souda H, Gunji H, Miyazaki A, Nojima H, Ikeda A, Matsumoto I, Ryu M, Makino H, Okazumi S (2007) Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection. Surg Endosc 21:1466–1468

    Article  PubMed  CAS  Google Scholar 

  12. Cho A, Yamamoto H, Nagata M, Takiguchi N, Shimada H, Kainuma O, Souda H, Gunji H, Miyazaki A, Ikeda A, Matsumoto I (2009) Safe and feasible inflow occlusion in laparoscopic liver resection. Surg Endosc 23:906–908

    Article  PubMed  Google Scholar 

  13. Makuuchi M, Hasegawa H, Yamazaki S (1986) Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet 161:346–350

    Google Scholar 

  14. Casting D, Garden J, Bismuth H (1989) Segmental liver resection using ultrasound-guided selective portal venous occlusion. Ann Surg 210:20–23

    Article  Google Scholar 

  15. Imamura H, Matsuyama Y, Miyagawa Y, Ishida K, Shimada R, Miyagawa S, Makuuchi M, Kawasaki S (1999) Prognostic significance of anatomical resection and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma. Br J Surg 86:1032–1038

    Article  PubMed  CAS  Google Scholar 

  16. Hasegawa K, Kokudo N, Imamura H, Matsuyama Y, Aoki T, Minagawa M, Sano K, Sugawara Y, Takayama T, Makuuchi M (2005) Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg 242:252–259

    Article  PubMed  Google Scholar 

  17. Machado MA, Makdissi FF, Galvão FH, Machado MC (2008) Intrahepatic Glissonian approach for laparoscopic right segmental liver resections. Am J Surg 196:38–42

    Article  Google Scholar 

  18. Topal B, Aerts R, Penninckx F (2007) Laparoscopic intrahepatic Glissonian approach for right hepatectomy is safe, simple, and reproducible. Surg Endosc 21:2111

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosures

Drs. Akihiro Cho, Hiroshi Yamamoto, Osamu Kainuma, Hiroaki Souda, Atsushi Ikeda, Nobuhiro Takiguchi, and Matsuo Nagata have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Akihiro Cho.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cho, A., Yamamoto, H., Kainuma, O. et al. Safe and feasible extrahepatic Glissonean access in laparoscopic anatomical liver resection. Surg Endosc 25, 1333–1336 (2011). https://doi.org/10.1007/s00464-010-1358-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1358-6

Keywords

Navigation