Histological Basis of the Liver Hanging Maneuver

Overview

Journal Surg Radiol Anat

Specialties Anatomy & Histology
General Surgery
Radiology

Date 2008 Nov 8

PMID 18989610

Citations 2

Authors

Sebastien Gaujoux

Patrick Barbet

Giuseppe Maria Ettorre

Jean-Marc Chevallier

Vincent Delmas

Richard Douard

Affiliations

Soon will be listed here.

Abstract

Background: Liver hanging maneuver (LHM) consists in passing a tape between the retrohepatic inferior vena cava (RHIVC) and the liver to perform various kinds of hepatectomies. LHM is a well-known procedure but its histological basis remains poorly documented.

Methods: Ten anatomical specimens comprising RHIVC, and surrounding hepatic parenchyma were studied after conventional staining and immunohistochemistry with specific antibody for alpha smooth muscle actin.

Results: RHIVC wall structure consists of a thick muscular layer of longitudinal smooth muscle fibers and a peripheral loose connective tissue without smooth muscle fibers adherent to the liver parenchyma. This loose connective tissue between the liver and the RHIVC is the avascular plane for the passage of the clamp during LHM.

Conclusion: The histological structure of the RHIVC does not seem to have any special hemostatic property. The low bleeding rate during LHM can be only explained by the very low density of RHIVC afferent veins.

Citing Articles

Anatomy of the retrohepatic segment of the inferior vena cava and the ostia venae hepaticae with its clinical significance.

Ghosh S, Paul S Surg Radiol Anat. 2011; 34(4):347-55.

PMID: 22146982 DOI: 10.1007/s00276-011-0915-6.

The liver hanging manoeuvre.

Liddo G, Buc E, Nagarajan G, Hidaka M, Dokmak S, Belghiti J HPB (Oxford). 2009; 11(4):296-305.

PMID: 19718356 PMC: 2727082. DOI: 10.1111/j.1477-2574.2009.00068.x.

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