title: Less cost by using hanging maneuver and Pringle maneuver in left lateral hepatectomy through small laparotomy wound--experience of Southern Taiwan.
abstract: BACKGROUND
  Laparoscopic segmentectomy for liver tumor located in the left lateral segment (LLS) is thought to be a standard protocol nowadays with several advantages, such as small wound, few blood loss, and short hospital stay. However, there are still many disadvantages during executing laparoscopic LLS segmentectomy. This manuscript aims to present the technique to execute LLS segmentectomy with small incision, hanging maneuver without Pringle maneuver in patients with tumor at LLS of the liver.
  
  
  METHODS
  Between November 2010 and July 2011, hepatectomies through small incision for nine patients with benign and malignant tumors were performed at Kaohsiung Chang Gung Memorial Hospital, Taiwan. Perioperative and postoperative results, such as operation time, blood loss, incisional width, and postoperative stay were used to determine consequents for this technique.
  
  
  RESULTS
  Results demonstrated that modified LLS segmentectomy by the author's team was performed successfully in patient with liver tumor with fewer blood loss, smaller incisional width, and lower hospital cost than traditional open surgery. In addition, the instrument cost and blood loss in our series were less than that in laparoscopic LLS segmentectomy in published literature.
  
  
  CONCLUSIONS
  Authors concluded that minimally incisional segmentectomy, with less cost and technical demanding, could be an alternative choice in patient with liver tumor at LLS.
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Ting-Lung
authors.initials: TL
authors.lastname: Lin
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Alikhanov
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Sheng-Chih
authors.initials: SC
authors.lastname: Kuo
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Li
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Chao-Long
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Shih-Ho
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Chih-Che
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Yueh-Wei
authors.initials: YW
authors.lastname: Liu
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Chee-Chien
authors.initials: CC
authors.lastname: Yong
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan.
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 833, Taiwan. ufel4996@ms26.hinet.net.
authors.forename: Chih-Chi
authors.initials: CC
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000191:economics / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000191:economics / Q000601:surgery; D006391:Hemangioma / Q000191:economics / Q000601:surgery*; D006498:Hepatectomy / Q000191:economics / Q000379:methods*; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007813:Laparotomy / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008113:Liver Neoplasms / Q000191:economics / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000379:methods*; D061646:Operative Time; D013624:Taiwan; D016896:Treatment Outcome