[The significance of liver hanging maneuver in liver-splitting anterior approach for hepatectomy].
OBJECTIVE
To analyze the feasibility of developing a tunnel between inferior vena cava (IVC) and caudate lobe before passing a tape through it, and to explore the significance of liver hanging maneuver in liver-splitting anterior approach for hepatectomy.


METHODS
Blunt dissection was used to develop the tunnel before a tape was passed through. A hemostatic plate was placed on the surface of liver parenchyma if needed. In the procedure of hepatectomy, the tape was pulled up to create an interspace between liver parenchyma and IVC so that the IVC can be protected during transection.


RESULTS
Liver hanging maneuver was performed successfully in 47 cases. There were no severe complications related to the procedure in these cases. The procedure was terminated in 1 case because of severe bleeding.


CONCLUSIONS
1. Liver hanging maneuver is feasible in terms of anatomy and technique. 2. With liver hanging maneuver, IVC can be protected safely and the intrahepatic vessels and ductal system at the transaction line can be exposed clearly. It also makes anterior approach for hepatectomy safer and easier.
Peng
Shu-you
SY
Second General Surgery Department, 2nd Affiliated Hospital to Zhejiang University Medical College, Hangzhou 310009, China.
Qian
Hao-ran
HR
Li
Jiang-tao
JT
Feng
Xue-dong
XD
Liu
Ying-bin
YB
Wang
Jian-wei
JW
Xu
Bin
B
Du
Jian-jun
JJ
Cao
Li-ping
LP
Fang
He-qing
HQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002648:Child; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged