Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Review Article Volume 3 Issue 12

Anatomical Basis of Approaches to Liver Resection

Madhusudhanan Jegadeesan1* and Ramprasad Jegadeesan2

1Hepatopancreaticobiliary and Liver Transplant Surgery Unit, Apollo Speciality Hospitals, Madurai, Tamilnadu, India
2Department of Gastroenterology, Southern Illinois University, IL, USA

*Corresponding Author: Madhusudhanan Jegadeesan, Consultant, Hepatopancreaticobiliary and Liver Transplant Surgery Unit, Apollo Speciality Hospitals, Madurai, Tamil Nadu, India.

Received: September 04, 2020; Published: November 25, 2020

×

Abstract

  Essential to successful and safe performance of any liver resection is the understanding of anatomical aspects pertaining to liver resection. The different approaches to liver resections reflect the different techniques and surgical maneuvers executed at specific anatomical regions in and around liver. The three approaches to liver resection, as put forth by Claude Couinaud, are the intrafascial, extrafascial and the extrafascial transfissural approach. The later two approaches are essentially dissection of Glissonean pedicles at the hilum of the liver. This Glissonean pedicle approach is facilitated by newer insights into anatomy of liver gained by modern pathological and surgical research. The Glissonean pedicle approach is safe as it achieves inflow control early in the process of liver resection and ontologically sound as it is an anatomical approach. It is also effective when employed during minimally invasive liver resections. Both intrafascial and extrafascial approaches are relevant in specific circumstances of liver resection. This chapter will specifically analyse the anatomical basis that surrounds the approaches to liver resection.

Keywords: Anatomical Hepatectomy; Glissonean Pedicle; Leannec Capsule; Major Hepatectomy; Limited Resection

×

References

  1. Strasberg SM., et al. “Isolation of right main and right sectional portal pedicles for liver resection without hepatotomy or inflow occlusion”. Journal of the American College of Surgeons 206 (2008): 390-396.
  2. Yamazaki O., et al. “Comparison of the outcomes between anatomical resection and limited resection for single hepatocellular carcinomas no larger than 5 cm in diameter: a single-center study”. Journal of Hepato-Biliary-Pancreatic Sciences 17 (2020): 349-358.
  3. Couinaud C. “The vasculo-biliary sheath”. In: Surgical anatomy of the liver revisited. Paris (1989).
  4. Lortat-Jacob JL and Robert HG. “Well defined technic for right hepatectomy”. La Presse Médicale 60 (1952): 549-551.
  5. Honjo I and Araki C. “Total resection of the right lobe of the liver; report of a successful case”. The Journal of the International College of Surgeons 1-1 (1955): 23-28.
  6. Bismuth H. “Surgical anatomy and anatomical surgery of the liver”. World Journal of Surgery 6 (1982): 3-9.
  7. Galperin EI and Karagiulian SR. “A new simplified method of selective exposure of hepatic pedicles for controlled hepatectomies”. HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery's 1 (1989): 119-130.
  8. Machado MAC., et al. “Intrahepatic Glissonian access for segmental liver resection in cirrhotic patients”. The American Journal of Surgery 192 (2006): 388-392.
  9. Machado MAC., et al. “Intrahepatic Glissonian approach for laparoscopic right segmental liver resections”. The American Journal of Surgery 196 (2008): e38-e42.
  10. Launois B and Jamieson GG. “The posterior intrahepatic approach for hepatectomy or removal of segments of the liver”. Surgery, Gynecology and Obstetrics 174 (1992): 155-158.
  11. Couinaud C., et al. “Le foie; études anatomiques et chirurgicales”. Paris: Masson and Cie (1957).
  12. Lin TY., et al. “Total right hepatic lobectomy for primary hepatoma”. Surgery 48 (1960): 1048-1060.
  13. Tung TT and Quang ND. “Segmentary hepatectomy by transparenchymatous vascular ligation”. La Presse Médicale 73 (1965): 3015-3017.
  14. Okamoto E. “Hepatic resection for primary hepatocellular carcinoma: New trials for controlled anatomic subsegmentectomies by an initial suprahilar Glissonian pedicular ligation method (in Japanese)”. Shokakigeka Seminar 23 (1986): 229-241.
  15. Couinaud CM. “A simplified method for controlled left hepatectomy”. Surgery 97 (1985): 358-361.
  16. Takasaki K., et al. “Highly anatomically systematized hepatic resection with Glissonean sheath code transection at the hepatic hilus”. International Journal of Surgery 75 (1990): 73-77.
  17. Walaeus J. “Epistolae duae de motu chyli et sanguinis ad Tho- mam Bartholeum”. Leiden: Fransciscus Hackius (1640).
  18. Glisson F. Anatomia hepatis. ap. Jo. Janss. a Waefberge (1665): 530.
  19. Yamamoto M., et al. “Tips for anatomical hepatectomy for hepatocellular carcinoma by the Glissonean pedicle approach (with videos)”. Journal of Hepato-Biliary-Pancreatic Sciences 21 (2014): E53-E56.
  20. Laennec RTH. “Lettre sur des Tuniques qui enveloppent certains Visc eres, et fournissentdes gaines membraneuses a leurs vaisseaux”. Journ De M ed Chir Et Pharm; Vend emiaire an XI (1802): 539-575.
  21. Couinaud C. “Liver lobes and segments: notes on the anatomical architecture and surgery of the liver”. La Presse Médicale 62 (1954): 709-712.
  22. Hayashi S., et al. “Connective tissue configuration in the human liver hilar region with special reference to the liver capsule and vascular sheath”. Japanese Society of Hepato-Biliary-Pancreatic Surgery 15 (2008): 640-647.
  23. Sugioka A., et al. “Systematic extrahepatic Glissonean pedicle isolation for anatomical liver resection based on Laennec’s capsule: proposal of a novel comprehensive surgical anatomy of the liver”. Journal of Hepato-Biliary-Pancreatic Sciences 24 (2017): 17-23.
  24. Yamamoto M., et al. “Glissonean pedicle transection method for liver surgery (with video)”. Journal of Hepato-Biliary-Pancreatic Sciences 19 (2012): 3-8.
  25. Yamamoto M., et al. “Effectiveness of systematized hepatectomy with Glisson’s pedicle transection at the hepatic hilus for small nodular hepatocellular carcinoma: retrospective analysis”. Surgery 130 (2001): 443-448.
  26. Yamamoto M., et al. “The value of anatomical liver sectionectomy for patients with a solitary hepatocellular carcinoma from 2 to 5 cm in greatest diameter”. Journal of Surgical Oncology 100 (2009): 585-588.
  27. Makuuchi M., et al. “Development of evidence-based clinical guidelines for the diagnosis and treatment of hepatocellular carcinoma in Japan”. Hepatology Research 38 (2008): 37-51.
  28. Takasaki K. “Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation”. Japanese Society of Hepato-Biliary-Pancreatic Surgery 5 (1998): 286-291.
  29. Fasel JHD., et al. “Liver segments: an anatomical rationale for explaining inconsistencies with Couinaud’s eight-segment concept”. Surgical and Radiologic Anatomy 32 (2010): 761-765.
  30. Majno P., et al. “Anatomy of the liver: an outline with three levels of complexity--a further step towards tailored territorial liver resections”. Journal of Hepatology 60 (2014): 654-662.
  31. Makuuchi M., et al. “Ultrasonically guided subsegmentectomy”. Surgery, Gynecology and Obstetrics 161 (1985): 346-350.
  32. Makuuchi M., et al. “Surgery for small liver cancers”. Seminars in Surgical Oncology 9 (1993): 298-304.
  33. Hasegawa K., et al. “Prognostic impact of anatomic resection for hepatocellular carcinoma”. Annals of Surgery 242 (2005): 252-259.
  34. Eguchi S., et al. “Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey”. Surgery 143 (2008): 469-475.
×

Citation

Citation: Madhusudhanan Jegadeesan and Ramprasad Jegadeesan. "Anatomical Basis of Approaches to Liver Resection". Acta Scientific Gastrointestinal Disorders 3.12 (2020): 17-23.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US