Hepatic trisectionectomy for hepatocellular carcinoma using the Glisson pedicle method combined with anterior approach.
BACKGROUND
Hepatic trisectionectomy is a challenge for surgeons. We describe a technique by combination of the Glisson pedicle method and anterior approach to perform hepatic trisectionectomy.


METHODS
In this technique, the Glisson pedicles are isolated above the hilar plate without hilar dissection. After dividing these pedicles, the hepatic hilum can be lowered more easily. With the hepatic hilum brought down, the following step of hepatic parenchyma transection using the anterior approach can be performed safely, avoiding accidental injury to the vessels and hepatic duct in the hilar plate.


CONCLUSIONS
This technique provides a safe, easy way to perform hepatic trisectionectomy without warm ischemia injury to the remnant liver.
Department of Liver Surgery & Liver Transplantation Centre, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China.
Kun-Lin
KL
Xie
Yong
Y
Zeng
Hong
H
Wu
D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D004210:Dissection / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D018579:Patient Selection; D055815:Young Adult