Immediate results of intrahepatic approach to glissonian pedicles for liver resections . São Paulo, 2003. 102 p. Tese (Livre-Docência) - Faculdade de Medicina. Universidade de São Paulo. Texto completo em pdf - portuguese (4,5Mb).


In the last years the experience with liver resection is increasing, so are the indications for segmental resections. During the period from July 2001 and January 2003, 27 patients that underwent liver resection according to a modified intrahepatic approach to glissonian pedicles were studied. There were 14 men and 13 women with mean age of 56.9 years (range 27-75). Clinical data were obtained from a prospective database. The modified technique was feasible in all cases. Blood transfusion was required in four patients (14.8%). No postoperative mortality was observed. The morbidity rate was 25.9%. Median hospital stay was six days. There was a learning curve to the intrahepatic access to glissonian pedicles. The modified technique was especially useful in patients with previous surgery over hepatic hilum. Segmental liver resection instead of a formal right hepatectomy was followed by a better postoperative liver function. It was concluded that the standardized technique is helpful in patients with previous interventions on the hepatic hilum and useful to spare liver parenchyma during resection of small or bilateral lesions. It may allow liver surgeons to rapidly gain access to the intrahepatic glissonian pedicles and perform segmental liver resections.