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. 2022 Jan;29(1):66-81.
doi: 10.1002/jhbp.898. Epub 2021 Feb 19.

Landmarks and techniques to perform minimally invasive liver surgery: A systematic review with a focus on hepatic outflow

Kazuteru Monden  1 , Felipe Alconchel  2 , Giammauro Berardi  3 , Ruben Ciria  4 , Keiichi Akahoshi  5 , Yoshihiro Miyasaka  6 , Takeshi Urade  7   8 , Alain García Vázquez  8 , Kiyoshi Hasegawa  9 , Goro Honda  10 , Hironori Kaneko  11 , Ji Hoon Kim  12 , Minoru Tanabe  5 , Masakazu Yamamoto  10 , Go Wakabayashi  13 ; Study group of Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic surgery (PAM-HBP surgery)
Collaborators, Affiliations

Landmarks and techniques to perform minimally invasive liver surgery: A systematic review with a focus on hepatic outflow

Kazuteru Monden et al. J Hepatobiliary Pancreat Sci. 2022 Jan.

Abstract

Purpose: In this systematic review, we aimed to clarify the useful anatomic structures and assess available surgical techniques and strategies required to safely perform minimally invasive anatomic liver resection (MIALR), with a particular focus on the hepatic veins (HVs).

Methods: A systematic review was conducted using MEDLINE/PubMed for English articles and Ichushi databases for Japanese articles through September 2020. The quality assessment of the articles was performed in accordance with the Scottish Intercollegiate Guidelines Network (SIGN).

Results: A total of 3372 studies were obtained, and 59 were selected and reviewed. Due to the limited number of published comparative studies and case series, the degree of evidence from our review was low. Thirty-two articles examined the anatomic landmarks and crucial structures for approaching HVs. Regarding the direction of HV exposure, 32 articles focused on the techniques and advantages of exposing HVs from either the root or the periphery. Ten articles focused on the techniques to perform a segmentectomy 8 in particularly difficult cases of MIALR. In seven articles, bleeding control from HVs was also discussed.

Conclusions: This review may help experts reach a consensus regarding the best approach to the management of hepatic veins during MIALR.

Keywords: hepatic outflow; hepatic vein injury; landmark; laparoscopic liver resection; minimally invasive anatomic liver resection.

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References

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