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Segment-oriented liver resections based on posterior intrahepatic glissonian approach


Authors: Doklestić Krstina, Đukić Vladimir, Bumbaširević Vesna, Jovanović Bojan, Karamarković Aleksandar Ž.
Published: Mar 30, 2012
Pages: 41-48
DOI: 10.2298/ACI1203041D


Background: Segment-oriented liver resections can be performed effective by posterior intrahepatic approach. A significance of such resection is that they are oncologically radical as well as parenchyma- sparing. Methodology: Segmental liver resections were performed in 102 patients with liver tumors. Suprahilar control of the appropriate glissonean pedicle was achieved by the posterior intrahepatic approach. Liver parenchyma was transsected by ultrasonic dissector, under intermittent vascular occlusion (IVO). Pedicle was divided at the end of resection using "endo-GIA" vascular stapler. Results: The overall transection time was 30,14+12,56 min. The amount of blood loss was 285,59+129,92 ml. The postoperative complication rate was 25,49%. R0 resection had 94 (92,16%) patients. There was no liver failure or perioperative death. Conclusions: Posterior intrahepatic approach for segmental resection is safe, can expedite the liver transection and reduce intraoperative hemorrhage. This approach provides adequate tumor clearance with preservation of normal parenchyma, as well as the vasculature or the biliary drainage of the contralateral liver.

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