Liver hanging maneuver decreases blood loss and operative time in a right-side hepatectomy

Hepatogastroenterology. 2012 Mar-Apr;59(114):542-5. doi: 10.5754/hge09737.

Abstract

Background/aims: To clarify the clinical benefits of the maneuver in right-side hepatectomy.

Methodology: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Blood Loss, Surgical / prevention & control*
  • Carcinoma, Hepatocellular / blood supply
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Erythrocyte Transfusion
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Hepatectomy / mortality
  • Humans
  • Liver Neoplasms / blood supply
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Plasma
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Tumor Burden