The preliminary experience of Belghiti's liver hanging manoeuvre in right hepatectomy with anterior approach

Abstract

Aim: To summarize the experience of Belghiti's liver hanging manoeuvre in right hepatectomy.Methods: Nine cases of right hepatectomy were performed with Belghiti's liver hanging manoeuvre from June 2002 to May 2005. They included seven cases of large hepatocellular carcinoma located in the right liver lobe with diameters from 8 to 12 cm (two have encroached diaphragm and lateral peritoneum) and two cases of recurrent pyogenic cholangitis with hepatolithiasis fully packed in the right liver lobe. The key step of this manoeuvre was to develop a retrohepatic tunnel between the anterior surface of the inferior vena cava and the liver parenchyma. A tape was then passed though the tunnel and the liver was resected under tape suspension.Results: The retrohepatic tunnel was established and the suspending tape was passed though the tunnel successfully in all cases. The mean time for this procedure was 21 min. Mean intraoperative blood loss was 380 mL. The middle hepatic veins were protected from damage in eight cases. There were no operative deaths or morbidity, except one case that developed postoperative bile leakage, which was cured by drainage.Conclusion: Belghiti's liver hanging manoeuvre is a preferred surgical method for right hepatectomy, with its reliable anatomic background and satisfactory primary clinical results.