Liver hanging maneuver: an anatomic and clinical review.
BACKGROUND
Liver hanging maneuver (LHM) allows to hang the liver during right hepatectomies without primary liver mobilization. The avascular plane used in this technique has been poorly described in the anatomical literature, and intraoperative bleeding because of hepatic vein injuries has been reported.


METHODS
Major clinical and anatomic articles focusing on the retrohepatic portion of the inferior vena cava (IVC) and the LHM were reviewed.


CONCLUSIONS
LHM is as an effective and safe method of guiding hepatic transection to the IVC during right hepatectomies with a feasibility rate up to 95% and minor bleeding in 0% to 6% of cases. According to small series and experts' opinions, LHM would improve parenchymal transection by reducing operative time and blood loss. The tape would ensure a linearly cut surface with IVC safer protection, better exposure, and hemostasis of the deeper plane. Limited remnant liver mobilization could reduce the risk for malignant dissemination and improve liver function. Hepatectomies for huge tumor with diaphragm adhesions could be facilitated.
Gaujoux
Sébastien
S
Paris V Faculty of Medicine, Paris Institute of Anatomy, 45, rue des Saints-Pères, 75006 Paris, France.
Douard
Richard
R
Ettorre
Giuseppe Maria
GM
Delmas
Vincent
V
Chevallier
Jean-Marc
JM
Cugnenc
Paul-Henri
PH
D004210:Dissection; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000293:injuries; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply / Q000601:surgery; D008340:Mandibular Nerve