Anatomy and clinical significance of hilar plate / 中国实用外科杂志

The concept of hepatic hilar plate was first proposed by Couinaud in 1957. After more than 60 years of exploration and clinical practice, the related techniques of hepatic hilar plate exposure, including lowering hepatic hilar plate technique, extra-glissonean pedicle approach technique,have been used in hepatic vascular inflow occlussion of open and laparoscopic anatomical hepatectomy, resection of hepatic hilar complex tumors, management of hepatolithiasis and traumatic benign stricture of high bile duct. Hilar plate detachment and glissonean pedicle approach technique are more and more widely used, which have become a compulsory course for hepatobiliary surgeons to reduce the difficulty of perihilar surgery and increase the safety of liver surgery.

Resection of centrally located primary liver cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To summarize the experience of hepatectomy for patients with centrally located primary liver cancer.</p><p><b>METHODS</b>The clinical data of patients with centrally and non-centrally located primary liver cancer were retrospectively reviewed. The biochemical indicators, operation duration, hepatic inflow occlusion time, hospital stay, operative blood loss, amount of blood transfusion, complication, and effectiveness of three occlusion methods (semi-hepatic inflow occlusion, Pringle's manoeuvre, and modified Pringle's manoeuvre) were analyzed.</p><p><b>RESULTS</b>Tumor diameter, Child-Pugh score, indocyanine green retention rate, aspartate aminotransferase, alanine aminotransferase, glutamyltransferase, total bilirubin, direct bilirubin, albumin, prealbumin, cholinesterase, hepatic inflow occlusion time, blood transfusion, postoperative complications, and operative blood loss were not significantly different between patients with centrally and non-centrally located primary liver cancer. Patients with centrally located liver cancer had significantly longer operation duration and hospital stay than patients with non-centrally located liver cancer (P < 0.05). The modified Pringle's manoeuvre of hepatic inflow occlusion had the same effectiveness of the Pringle's manoeuvre and could be performed in a simpler way.</p><p><b>CONCLUSIONS</b>Hepatectomy is safe and feasible for patients with centrally located primary liver cancer. Appropriate preoperative evaluation and preparation, sufficient knowledge of liver anatomy, and proper selection of hepatic inflow occlusion method are key factors to guarantee the success of the resection.</p>