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. 2022 Jan;29(1):51-65.
doi: 10.1002/jhbp.908. Epub 2021 Feb 23.

Glissonean approach for hepatic inflow control in minimally invasive anatomic liver resection: A systematic review

Mamoru Morimoto  1 , Federico Tomassini  2 , Giammauro Berardi  3 , Yasuhisa Mori  4 , Chikara Shirata  5 , Mohammed Abu Hilal  6 , Horacio J Asbun  7 , Daniel Cherqui  8 , Naoto Gotohda  9 , Ho-Seong Han  10 , Yutaro Kato  11 , Fernando Rotellar  12 , Atsushi Sugioka  11 , Masakazu Yamamoto  13 , Go Wakabayashi  14 ; Study group of Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic surgery (PAM-HBP surgery)
Collaborators, Affiliations

Glissonean approach for hepatic inflow control in minimally invasive anatomic liver resection: A systematic review

Mamoru Morimoto et al. J Hepatobiliary Pancreat Sci. 2022 Jan.

Abstract

Background: The Glissonean approach has been widely validated for both open and minimally invasive anatomic liver resection (MIALR). However, the possible advantages compared to the conventional hilar approach are still under debate. The aim of this systematic review was to evaluate the application of the Glissonean approach in MIALR.

Methods: A systematic review of the literature was conducted on PubMed and Ichushi databases. Articles written in English or Japanese were included. From 2,390 English manuscripts evaluated by title and abstract, 43 were included. Additionally, 23 out of 463 Japanese manuscripts were selected. Duplicates were removed, including the most recent manuscript.

Results: The Glissonean approach is reported for both major and minor MIALR. The 1st, 2nd and 3rd order divisions of both right and left portal pedicles can be reached following defined anatomical landmarks. Compared to the conventional hilar approach, the Glissonean approach is associated with shorter operative time, lower blood loss, and better peri-operative outcomes.

Conclusions: Glissonean approach is safe and feasible for MIALR with several reported advantages compared to the conventional hilar approach. Clear knowledge of Laennec's capsule anatomy is necessary and serves as a guide for the dissection. However, the best surgical approach to be performed depends on surgeon experience and patients' characteristics. Standardization of the Glissonean approach for MIALR is important.

Keywords: Glissonean approach; hepatic inflow control; laparoscopic liver surgery; liver anatomy; liver resection.

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References

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