Right hepatectomy using the liver double-hanging maneuver through the retrohepatic avascular tunnel on the right of the inferior vena cava
Right hepatectomy using the liver double-hanging maneuver through the retrohepatic avascular tunnel on the right of the inferior vena cava
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DOI：
10.1016/j.surg.2008.08.006
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发表时间：
2008-11-01
期刊：
影响因子：
3.8
通讯作者：
Qiu, Fa Zu
中科院分区：
文献类型：
--
作者：
Chen, Xiao Ping;Zhang, Wan Guang;Qiu, Fa Zu
背景。Belghiti悬肝术的关键是建立肝后隧道。该手术需要对下腔静脉（IVC）前平面进行盲剥离，有损伤短肝静脉和随之而来出血的固有风险。本文介绍一种技术简单、安全的肝双吊手法。操作者用他或她的右手食指解剖空间从。下面向上在肝实质和右肾上腺的前上边缘之间，就在这里。在下腔静脉右侧。术者用左手食指自上向下解剖肝上静脉右侧肝后间隙，肝上静脉与右肝静脉连接处外侧。用肾蒂钳在肝脏周围放置2根胶带进行悬吊。共有65例患者采用该术式行右肝切除术，其中62例为肝细胞癌（肿瘤大小：平均+/- SD， 10 +/- 3.7 cm）， 3例为肝海绵状血管瘤，最大直径分别为12.6 cm、14.4 cm和22.6 cm。肝后隧道建立过程中无大出血，成功率100%。在下腔静脉右侧空间建立肝后隧道绝对是不流血的，在技术上是简单和安全的。(手术2008;144:830-3)。
Background. The key to Belghiti's liver-hanging maneuver is to develop a retrohepatic tunnel. This procedure requires a blind dissection of the plane anterior to the inferior vena cava (IVC), with the inherent risks of damaging the short hepatic veins and consequential bleeding. The aim of this article is to describe a liver double-hanging maneuver with the advantage of being technically simple and safe.Methods. The operator uses his or her right index finger to dissect the space from. below upward between the hepatic parenchyma and the anterior and superior edge of the right adrenal gland, which is situated just. on the right side of the IVC. The operator then uses his left index finger to dissect the retrohepatic space from above downward on the right side of suprahepatic IVC, which is lateral to Where the right hepatic vein joins the IVC. The retrohepatic tunnel built when the 2 fingers touch each other A kidney pedicle forceps is used to place 2 tapes around the liver for suspension.Results. In all, 65 patients underwent right hepatectomy using this maneuver The study included 62 patients with hepatocellular carcinoma, (tumor size: mean +/- SD, 10 +/- 3.7 cm), and 3 patients had hepatic cavernous hemangioma, with a maximum diameter of 12.6 cm, 14.4 cm, and 22.6 cm, respectively. No major bleeding was encountered during the creation of the retrohepatic tunnel, with a success rate of 100%.Conclusion. To develop the retrohepatic tunnel in the space on the right of the IVC is absolutely bloodless, and it is technically easy and safe. (Surgery 2008;144:830-3.)