Artigo Produção Nacional Revisado por pares

Intrahepatic Glissonian access for segmental liver resection in cirrhotic patients

2006; Elsevier BV; Volume: 192; Issue: 3 Linguagem: Inglês

10.1016/j.amjsurg.2006.01.017

ISSN

1879-1883

Autores

Marcel Autran C. Machado, Paulo Herman, Estela Regina Ramos Figueira, Telésforo Bacchella, Marcel Cerqueira César Machado,

Tópico(s)

Organ Transplantation Techniques and Outcomes

Resumo

The main goal of segmental technique is to preserve the maximum amount of liver parenchyma. Liver-preserving techniques are especially important for patients with hepatocellular carcinoma and cirrhosis. We report the technique for segmental liver resection in cirrhotic patients and detail technical difficulties and immediate surgical outcome. For right segmental liver resections the intrahepatic access is performed through small incisions around the hilar plate. Left segmental resection technique also consists of small incisions following specific anatomic landmarks. Nineteen cirrhotic patients underwent segmental liver resections. A blood transfusion was required in 2 patients. No patient experienced major bleeding from the liver incisions made for intrahepatic access. The median hospital stay was 5 days. No surgical mortality occurred. The intrahepatic access technique allows individual resections of liver segments and is feasible even in cirrhotic patients. Knowledge of segmental liver resection techniques is an essential armamentarium in the modern era of liver surgery.

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