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Ji Hoon Kim - One of the best experts on this subject based on the ideXlab platform.

  • ventral approach to the middle hepatic vein during laparoscopic Hemihepatectomy
    Annals of Surgical Oncology, 2019
    Co-Authors: Ji Hoon Kim
    Abstract:

    The caudal approach constitutes a conceptual change in laparoscopic hepatectomy.1–4 The middle hepatic vein (MHV) located in the midplane of the liver serves as a landmark during Hemihepatectomy.5 However, it is difficult to expose the MHV from its peripheral branches toward the main root via the caudal approach because of anatomical variations in branching patterns.6 We present the ventral approach to the MHV during laparoscopic Hemihepatectomy. The ventral approach involves liver transection from the ventral to the dorsal aspect using a flexible laparoscope, similar to an open hepatectomy.7 The key characteristic of the ventral approach is early transection of the cranial portion of the liver, which facilitates accurate transection and maintains an open cutting plane. After achieving a wide surgical plane, the MHV is exposed from the main root toward its peripheral branches. The plane of parenchymal transection is easily modified based on the type of Hemihepatectomy. This technique was used in 15 patients between March 2016 and July 2018, of whom 7 underwent right Hemihepatectomy and 8 underwent left Hemihepatectomy. The median operative time was 240 min (range 180–410), and the intraoperative blood loss was 150 mL (range 80–310). The median postoperative hospital stay was 8 days (range 5–14). No major postoperative morbidity or mortality was reported. The ventral approach to the MHV involving exposure of the vein from the main trunk toward its peripheral branches may be an effective and feasible technique during laparoscopic Hemihepatectomy.

  • a modified liver hanging maneuver in pure laparoscopic left Hemihepatectomy with preservation of the middle hepatic vein video and technique
    Journal of Gastrointestinal Surgery, 2017
    Co-Authors: Ji Hoon Kim, Jaewoon Choi
    Abstract:

    The liver hanging maneuver is a novel and useful technique that is widely used in open liver resections. The present study describes the surgical technique and outcomes of a modified liver hanging maneuver for pure laparoscopic left Hemihepatectomy. The clinical data of patients who underwent laparoscopic left Hemihepatectomy using a modified hanging technique were retrospectively reviewed. The upper end of the hanging tape was placed on the lateral side of the left hepatic vein. The pathway of the tape was situated along the ligamentum venosum. Sixteen patients underwent pure laparoscopic left Hemihepatectomy with the modified hanging technique. The median operation time was 225 min (range 180–300 min), with a median blood loss of 265 ml (range 140–600 ml). Postoperative major complications occurred in one patient (6.3%). The median postoperative hospital stay was 8 days (range 5–15 days). There was no postoperative liver failure or mortality. This modified liver hanging maneuver is a simple, safe, and reproducible approach as dissection of between the middle and left hepatic vein is not required. This technique may be useful in laparoscopic left Hemihepatectomy.

  • a modified liver hanging maneuver in pure laparoscopic left Hemihepatectomy with preservation of the middle hepatic vein video and technique
    Journal of Gastrointestinal Surgery, 2017
    Co-Authors: Ji Hoon Kim, Jaewoon Choi
    Abstract:

    Background The liver hanging maneuver is a novel and useful technique that is widely used in open liver resections. The present study describes the surgical technique and outcomes of a modified liver hanging maneuver for pure laparoscopic left Hemihepatectomy.

Jaewoon Choi - One of the best experts on this subject based on the ideXlab platform.

Norihiro Kokudo - One of the best experts on this subject based on the ideXlab platform.

  • anatomical boundary between the caudate lobe of the liver and adjacent segments based on three dimensional analysis for precise resections
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Harufumi Maki, Yoshihiro Sakamoto, Yoshikuni Kawaguchi, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa, Norihiro Kokudo
    Abstract:

    Background Right Hemihepatectomy or systematic resection of segment 7 or 8 involves partial resection of the paracaval portion of the caudate lobe. However, the boundary between the caudate lobe and segment 7 or 8 remains unclear. We examined the anatomical territory of the caudate lobe with special reference to the boundary between the paracaval portion and segment 7 or 8 for precise anatomical hepatectomies.

  • aggressive Hemihepatectomy combined with resection and reconstruction of middle hepatic vein for intrahepatic cholangiocarcinoma
    Annals of Surgical Oncology, 2016
    Co-Authors: Akinori Miyata, Yoshihiro Sakamoto, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa, Satoshi Yamamoto, Norihiro Kokudo
    Abstract:

    Major hepatectomy for intrahepatic cholangiocarcinoma (ICC) sometimes involves resection of major hepatic veins, which might result in the future liver remnant (FLR) congestion. The necessity and efficacy of resection and reconstruction of the middle hepatic vein (MHV) during right or left Hemihepatectomy for resection of ICC remains unclear. Between 1995 and 2013, 68 patients underwent right (n = 24) or left Hemihepatectomy (n = 44) for primary ICC, with (n = 27) or without (n = 41) resection of MHV. If the noncongested FLR volume was <40 % of the total liver volume, reconstruction of major hepatic veins was considered. No significant differences between the groups were observed for patients with or without resection of MHV in the pathologic findings, including negative surgical margins (81 vs. 85 %, P = 0.67) and overall survival (5-year survival rate: 18.3 vs. 33.4 %, P = 0.26). In five patients who underwent venous resection and reconstruction, the noncongested FLR increased from 37 to 74 % after reconstruction (P < 0.01); this noncongested FLR was almost similar to the patients without venous resection (72 %). Three patients undergoing venous resection without reconstruction developed postoperative hepatic failure (grade A in 2 and grade B in 1; International study group of liver surgery definition); however, there was no surgical mortality. Aggressive Hemihepatectomy for ICC with venous resection in the FLR resulted in acceptable long-term outcome with no mortality when considering hepatic venous reconstruction based on our criterion.

  • Is extended Hemihepatectomy plus pancreaticoduodenectomy justified for advanced bile duct cancer and gallbladder cancer
    Surgery, 2013
    Co-Authors: Yoshihiro Sakamoto, Satoshi Nara, Yoji Kishi, Minoru Esaki, Kazuaki Shimada, Norihiro Kokudo, Tomoo Kosuge
    Abstract:

    Background Major hepatopancreaticoduodenectomy (HPD) is an extensive surgical procedure offering the highest curability for patients with advanced biliary cancer. However, surgical morbidity associated with major HPD is high, and optimal indications for this procedure remain unclear. Methods Between 1989 and 2010, 14 patients with widespread bile duct cancer and 5 with gallbladder cancer having biliary infiltration underwent major HPD at our hospital. Preoperative portal vein embolization was performed in 17 patients undergoing right HPD. Clinicopathologic factors and survivals following HPD were compared between patients with bile duct cancer and those with gallbladder cancer. Results One patient who underwent right HPD for gallbladder cancer died of hepatic failure (5.3%) and 18 of the 19 patients (95%) developed postoperative pancreatic fistulas. The median hospital stay was 47 days. Depth of invasion was T3 in 1 patient and T4 in 2 patients with bile duct cancer and was T4 in all 5 patients with gallbladder cancer (P = .002). The clinical stage was IV in 3 patients (21%) with bile duct cancer and in all 5 patients with gallbladder cancer (P = .002). The 5-year survival rates and median survival rates of patients with bile duct cancer and gallbladder cancer were 45% vs 0 and 3.3 years vs 8 months, respectively (P Conclusion HPD can be an acceptable treatment option for widespread bile duct cancer. However, the indication for HPD in advanced-stage gallbladder cancer should be considered carefully, considering the high morbidity rate and the advanced stage of the disease.

Jing Jia - One of the best experts on this subject based on the ideXlab platform.

Yoshihiro Sakamoto - One of the best experts on this subject based on the ideXlab platform.

  • anatomical boundary between the caudate lobe of the liver and adjacent segments based on three dimensional analysis for precise resections
    Journal of Gastrointestinal Surgery, 2018
    Co-Authors: Harufumi Maki, Yoshihiro Sakamoto, Yoshikuni Kawaguchi, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa, Norihiro Kokudo
    Abstract:

    Background Right Hemihepatectomy or systematic resection of segment 7 or 8 involves partial resection of the paracaval portion of the caudate lobe. However, the boundary between the caudate lobe and segment 7 or 8 remains unclear. We examined the anatomical territory of the caudate lobe with special reference to the boundary between the paracaval portion and segment 7 or 8 for precise anatomical hepatectomies.

  • aggressive Hemihepatectomy combined with resection and reconstruction of middle hepatic vein for intrahepatic cholangiocarcinoma
    Annals of Surgical Oncology, 2016
    Co-Authors: Akinori Miyata, Yoshihiro Sakamoto, Nobuhisa Akamatsu, Junichi Kaneko, Junichi Arita, Kiyoshi Hasegawa, Satoshi Yamamoto, Norihiro Kokudo
    Abstract:

    Major hepatectomy for intrahepatic cholangiocarcinoma (ICC) sometimes involves resection of major hepatic veins, which might result in the future liver remnant (FLR) congestion. The necessity and efficacy of resection and reconstruction of the middle hepatic vein (MHV) during right or left Hemihepatectomy for resection of ICC remains unclear. Between 1995 and 2013, 68 patients underwent right (n = 24) or left Hemihepatectomy (n = 44) for primary ICC, with (n = 27) or without (n = 41) resection of MHV. If the noncongested FLR volume was <40 % of the total liver volume, reconstruction of major hepatic veins was considered. No significant differences between the groups were observed for patients with or without resection of MHV in the pathologic findings, including negative surgical margins (81 vs. 85 %, P = 0.67) and overall survival (5-year survival rate: 18.3 vs. 33.4 %, P = 0.26). In five patients who underwent venous resection and reconstruction, the noncongested FLR increased from 37 to 74 % after reconstruction (P < 0.01); this noncongested FLR was almost similar to the patients without venous resection (72 %). Three patients undergoing venous resection without reconstruction developed postoperative hepatic failure (grade A in 2 and grade B in 1; International study group of liver surgery definition); however, there was no surgical mortality. Aggressive Hemihepatectomy for ICC with venous resection in the FLR resulted in acceptable long-term outcome with no mortality when considering hepatic venous reconstruction based on our criterion.

  • Is extended Hemihepatectomy plus pancreaticoduodenectomy justified for advanced bile duct cancer and gallbladder cancer
    Surgery, 2013
    Co-Authors: Yoshihiro Sakamoto, Satoshi Nara, Yoji Kishi, Minoru Esaki, Kazuaki Shimada, Norihiro Kokudo, Tomoo Kosuge
    Abstract:

    Background Major hepatopancreaticoduodenectomy (HPD) is an extensive surgical procedure offering the highest curability for patients with advanced biliary cancer. However, surgical morbidity associated with major HPD is high, and optimal indications for this procedure remain unclear. Methods Between 1989 and 2010, 14 patients with widespread bile duct cancer and 5 with gallbladder cancer having biliary infiltration underwent major HPD at our hospital. Preoperative portal vein embolization was performed in 17 patients undergoing right HPD. Clinicopathologic factors and survivals following HPD were compared between patients with bile duct cancer and those with gallbladder cancer. Results One patient who underwent right HPD for gallbladder cancer died of hepatic failure (5.3%) and 18 of the 19 patients (95%) developed postoperative pancreatic fistulas. The median hospital stay was 47 days. Depth of invasion was T3 in 1 patient and T4 in 2 patients with bile duct cancer and was T4 in all 5 patients with gallbladder cancer (P = .002). The clinical stage was IV in 3 patients (21%) with bile duct cancer and in all 5 patients with gallbladder cancer (P = .002). The 5-year survival rates and median survival rates of patients with bile duct cancer and gallbladder cancer were 45% vs 0 and 3.3 years vs 8 months, respectively (P Conclusion HPD can be an acceptable treatment option for widespread bile duct cancer. However, the indication for HPD in advanced-stage gallbladder cancer should be considered carefully, considering the high morbidity rate and the advanced stage of the disease.