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01.03.2009 | Anatomic Bases of Medical, Radiological and Surgical Teaching Anatomy

Histological basis of the liver hanging maneuver

verfasst von: Sebastien Gaujoux, Patrick Barbet, Giuseppe Maria Ettorre, Jean-Marc Chevallier, Vincent Delmas, Richard Douard

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 3/2009

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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.

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Titel: Histological basis of the liver hanging maneuver
verfasst von: Sebastien Gaujoux
Patrick Barbet
Giuseppe Maria Ettorre
Jean-Marc Chevallier
Vincent Delmas
Richard Douard
Publikationsdatum: 01.03.2009
Verlag: Springer-Verlag
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 3/2009
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-008-0437-z

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Histological basis of the liver hanging maneuver