title: The liver hanging maneuver in laparoscopic liver resection: a systematic review.
abstract: OBJECTIVE
  Laparoscopic surgery has gained the acceptance of the hepatobiliary surgical community and expert teams are now advocating major laparoscopic liver resections (LLRs). In this setting, the liver hanging maneuver (LHM) has been described in numerous series. We conducted a systematic review to investigate the effectiveness of the LHM in LLR.
  
  
  METHODS
  We performed an electronic literature search using PubMed, EMBASE, and COCHRANE databases. The final search was carried out in December, 2015.
  
  
  RESULTS
  We found 11 articles describing a collective total of 104 surgical procedures that were eligible for this study. Laparoscopic LHM was used in LLR for both benign and malignant conditions, and also in living donor liver transplantation (LDLT). The LHM was used mainly in right hepatectomy and only two authors reproduced the original LHM. We investigated the intraoperative parameters, preservation of postoperative liver function, and oncological outcomes. The clear benefit of using the LHM in LLR is for better identification of the parenchymal transection plane with less blood loss. The other benefits of LHM could not be corroborated by solid data on its positive value.
  
  
  CONCLUSIONS
  In view of the data published in the literature, our findings are not strong enough to support the systematic use of LHM in LLR.
authors.affiliation: Department of General, Digestive, and Endocrine Surgery, Robert Debré University-Hospital, Ave Général Koenig, 51100, Reims, France. Rhaiem14@gmail.com.|Department of Digestive Surgery A, La Rabta University Hospital of Tunis, Tunis, Tunisia. Rhaiem14@gmail.com.|University of Champagne-Ardennes, Reims, France. Rhaiem14@gmail.com.
authors.forename: Rami
authors.identifier: http://orcid.org/0000-0002-8569-6523
authors.initials: R
authors.lastname: Rhaiem
authors.affiliation: Department of General, Digestive, and Endocrine Surgery, Robert Debré University-Hospital, Ave Général Koenig, 51100, Reims, France.|University of Champagne-Ardennes, Reims, France.
authors.forename: Tullio
authors.initials: T
authors.lastname: Piardi
authors.affiliation: Department of Digestive Surgery A, La Rabta University Hospital of Tunis, Tunis, Tunisia.
authors.forename: Tarek
authors.initials: T
authors.lastname: Kellil
authors.affiliation: Department of General, Digestive, and Endocrine Surgery, Robert Debré University-Hospital, Ave Général Koenig, 51100, Reims, France.|University of Champagne-Ardennes, Reims, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Cagniet
authors.affiliation: Department of General, Digestive, and Endocrine Surgery, Robert Debré University-Hospital, Ave Général Koenig, 51100, Reims, France.|University of Champagne-Ardennes, Reims, France.
authors.forename: Mikael
authors.initials: M
authors.lastname: Chetboun
authors.affiliation: Department of General, Digestive, and Endocrine Surgery, Robert Debré University-Hospital, Ave Général Koenig, 51100, Reims, France.|University of Champagne-Ardennes, Reims, France.
authors.forename: Reza
authors.initials: R
authors.lastname: Kianmanesh
authors.affiliation: Department of General, Digestive, and Endocrine Surgery, Robert Debré University-Hospital, Ave Général Koenig, 51100, Reims, France.|University of Champagne-Ardennes, Reims, France.
authors.forename: Daniele
authors.initials: D
authors.lastname: Sommacale
mesh_terms: D016206:Databases, Bibliographic; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000601:surgery*; D016896:Treatment Outcome
keywords: Hanging; Laparoscopy; Liver resections