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Article: Anterior approach for difficult major right hepatectomy

TitleAnterior approach for difficult major right hepatectomy
Authors
Issue Date1996
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/
Citation
World Journal Of Surgery, 1996, v. 20 n. 3, p. 314-318 How to Cite?
AbstractIn selected patients with huge right hepatic tumors that had infiltrated the surrounding structures, injudicious mobilization of the liver before transection, as in the conventional manner, may result in excessive bleeding, prolonged ischemia from rotation of the hepatoduodenal ligament, and spillage of cancer cells into the systemic circulation. Alternatively, the 'anterior' approach, which involves initial completion of the parenchymal transection before the right hepatic lobe is mobilized, can be adopted for these patients with difficult right hepatic tumors. After hilar control of the inflow vessels, liver parenchyma was transected using an ultrasonic dissector until the anterior surface of the inferior vena cava is exposed. The right hepatic lobe is then mobilized laterally by securing all venous tributaries, including the right hepatic vein. The prospective data of 25 patients who had major right hepatectomy using the 'anterior' approach were compared with data from 34 patients who had their operation performed in the conventional manner. Despite the facts that larger tumors (p < 0.004), more extrahepatic structures (p < 0.05), and the caudate lobes (p < 0.03) were resected, the amount of perioperative blood transfusion, fluid replacement, and outcome between the two groups of patients were comparable. There were three hospital deaths, among which one could be attributed to an intraoperative catastrophe during hepatectomy using the conventional approach. The 'anterior' approach is a safe, effective option for selected patients undergoing complicated major right hepatectomy.
Persistent Identifierhttp://hdl.handle.net/10722/172724
ISSN
2015 Impact Factor: 2.523
2015 SCImago Journal Rankings: 1.375
References

 

DC FieldValueLanguage
dc.contributor.authorLai, ECSen_US
dc.contributor.authorFan, STen_US
dc.contributor.authorLo, CMen_US
dc.contributor.authorChu, KMen_US
dc.contributor.authorLiu, CLen_US
dc.date.accessioned2012-10-30T06:24:30Z-
dc.date.available2012-10-30T06:24:30Z-
dc.date.issued1996en_US
dc.identifier.citationWorld Journal Of Surgery, 1996, v. 20 n. 3, p. 314-318en_US
dc.identifier.issn0364-2313en_US
dc.identifier.urihttp://hdl.handle.net/10722/172724-
dc.description.abstractIn selected patients with huge right hepatic tumors that had infiltrated the surrounding structures, injudicious mobilization of the liver before transection, as in the conventional manner, may result in excessive bleeding, prolonged ischemia from rotation of the hepatoduodenal ligament, and spillage of cancer cells into the systemic circulation. Alternatively, the 'anterior' approach, which involves initial completion of the parenchymal transection before the right hepatic lobe is mobilized, can be adopted for these patients with difficult right hepatic tumors. After hilar control of the inflow vessels, liver parenchyma was transected using an ultrasonic dissector until the anterior surface of the inferior vena cava is exposed. The right hepatic lobe is then mobilized laterally by securing all venous tributaries, including the right hepatic vein. The prospective data of 25 patients who had major right hepatectomy using the 'anterior' approach were compared with data from 34 patients who had their operation performed in the conventional manner. Despite the facts that larger tumors (p < 0.004), more extrahepatic structures (p < 0.05), and the caudate lobes (p < 0.03) were resected, the amount of perioperative blood transfusion, fluid replacement, and outcome between the two groups of patients were comparable. There were three hospital deaths, among which one could be attributed to an intraoperative catastrophe during hepatectomy using the conventional approach. The 'anterior' approach is a safe, effective option for selected patients undergoing complicated major right hepatectomy.en_US
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00268/en_US
dc.relation.ispartofWorld Journal of Surgeryen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshCarcinoma, Hepatocellularen_US
dc.subject.meshFemaleen_US
dc.subject.meshHepatectomy - Methodsen_US
dc.subject.meshHepatitis, Chronic - Pathology - Surgeryen_US
dc.subject.meshHumansen_US
dc.subject.meshIntraoperative Complications - Etiology - Prevention & Controlen_US
dc.subject.meshLiver - Pathologyen_US
dc.subject.meshLiver Cirrhosis - Pathology - Surgeryen_US
dc.subject.meshLiver Neoplasms - Pathology - Surgeryen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.titleAnterior approach for difficult major right hepatectomyen_US
dc.typeArticleen_US
dc.identifier.emailFan, ST: stfan@hku.hken_US
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_US
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.identifier.authorityLo, CM=rp00412en_US
dc.identifier.authorityChu, KM=rp00435en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1007/s002689900050en_US
dc.identifier.pmid8661837-
dc.identifier.scopuseid_2-s2.0-0029994572en_US
dc.identifier.hkuros22178-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0029994572&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume20en_US
dc.identifier.issue3en_US
dc.identifier.spage314en_US
dc.identifier.epage318en_US
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLai, ECS=55187396300en_US
dc.identifier.scopusauthoridFan, ST=7402678224en_US
dc.identifier.scopusauthoridLo, CM=7401771672en_US
dc.identifier.scopusauthoridChu, KM=7402453538en_US
dc.identifier.scopusauthoridLiu, CL=7409789712en_US

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