SURGICAL TECHNIQUE Two Hundred Liver Hanging Maneuvers for Major

Objective: To establish the indications of the liver hanging maneu-ver for major hepatectomy. Summary Background Data: The liver hanging maneuver, which is a technique of passing a tape along the retrohepatic avascular space and suspending the liver during parenchymal transection, facilitates anterior approach of major hepatectomy. However, the feasibility and limits of this maneuver have never been established in patients with different clinical backgrounds. Methods: Medical records of 242 consecutive patients considered for major hepatectomy using the hanging maneuver were reviewed. Results: Among 242 patients, 14 patients (6%) were considered to have contraindication for this maneuver preoperatively because of tumor infiltration to anterior surface of retrohepatic inferior vena cava (IVC). It was successful in 201 patients with overall feasibility of 88%. The feasibility increased significantly in the recent years a