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Ban et al. Hepatoma Res 2021;7:13 Hepatoma Research
DOI: 10.20517/2394-5079.2020.104

Review Open Access

Revisiting the role of the hepatic vein in
laparoscopic liver resection

Daisuke Ban, Satoshi Nara, Takeshi Takamoto, Takahiro Mizui, Jun Yoshino, Minoru Esaki, Kazuaki
Shimada

Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Correspondence to: Dr. Daisuke Ban, Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital,
5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. E-mail: dban@ncc.go.jp
How to cite this article: Ban D, Nara S, Takamoto T, Mizui T, Yoshino J, Esaki M, Shimada K. Revisiting the role of the hepatic vein
in laparoscopic liver resection. Hepatoma Res 2021;7:13. http://dx.doi.org/10.20517/2394-5079.2020.104
Received: 13 Sep 2020 First Decision: 9 Nov 2020 Revised: 10 Nov 2020 Accepted: 17 Nov 2020 Published: 3 Feb 2021

Academic Editor: Ho-Seong Han Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Laparoscopic liver resection (LLR) has expanded to include major liver resection and systematic resection as the
Received: First Decision: Revised: Accepted: Published:
techniques have advanced. Regardless of the oncological significance of anatomical resection, dissection of the
Science Editor: Copy Editor: Production Editor: Jing Yu intersegmental plane is useful in liver resection because it makes liver dissection easier and does not leave an
ischemic area. In laparoscopic surgery, the hepatic vein can be exposed with less bleeding than in open surgery
because bleeding can be controlled by pneumoperitoneum pressure. Therefore, the hepatic vein is a useful
indicator to guide the dissected surface and to determine the depth. However, the basic technique of exposing
the hepatic vein during LLR is required. The hepatic vein root can be approached using either a cranial or dorsal
approach, with the dorsal approach providing the favorable view characteristic of laparoscopy. Selecting the
dissection layer with the Laennec’s capsule of the hepatic vein roots in mind is also a useful technique to ensure
more reliable dissection of the hepatic vein. We summarize previous reports on techniques for facilitating LLR
using the hepatic vein as a guide and outline the role of each hepatic vein type. Although there are many reports of
procedures using the hepatic vein as a guide, the terminology of the approach awaits standardization in the future.

Keywords: Laparoscopic liver resection, laparoscopic hepatectomy, hepatic vein, anatomical landmark

INTRODUCTION
Initially limited to minor liver resections, laparoscopic liver resection (LLR) has been expanded to include
[1]
major liver resection and systematic resection as techniques have advanced . Although there has been
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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