title: Liver hanging maneuver decreases blood loss and operative time in a right-side hepatectomy.
abstract: OBJECTIVE
  To clarify the clinical benefits of the maneuver in right-side hepatectomy.
  
  
  METHODS
  Eighty-one patients with liver tumor (54 hepatocellular carcinoma, 17 metastatic liver tumor and 10 other tumors) treated with a right-side hepatectomy were prospectively analyzed. The patients were divided into the following three groups: a conventional approach (group A, n=21); liver dissection under the hanging maneuver after liver mobilization (group B, n=19) and liver dissection under the hanging maneuver prior to liver mobilization (group C, n=41).
  
  
  RESULTS
  The liver hanging maneuver was safely performed in all the patients in groups B and C. Tumor size had a significantly positive correlation with the amount of intraoperative blood loss (R=0.52, p<0.05) in group A only. The patients in groups B and C had a significantly lower intraoperative use of blood loss (both p<0.01), operation time (p<0.05 and p<0.01) and the frequency of blood product (both p<0.05), in comparison to group A, respectively. The postoperative morbidity and the mortality rates were similar in the three groups.
  
  
  CONCLUSIONS
  Liver hanging maneuver is a safe procedure, which can decrease intraoperative blood loss and administration of blood product in right-side hepatectomy.
authors.affiliation: Department of Gastroenterology Surgery, Kumamoto University, Kumamoto, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Komori
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Ryu
authors.initials: R
authors.lastname: Otao
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Jiro
authors.initials: J
authors.lastname: Nasu
authors.forename: Kei
authors.initials: K
authors.lastname: Horino
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017707:Erythrocyte Transfusion; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden