To our knowledge this is the first report to provide a detailed description of\nsurgical procedure for adhesiolysis and hepatectomy in patients who have\nundergone esophagectomy and reconstruction. We performed a hepatic resection\nof the left medial segment in a patient with a reconstructed stomach\ntube after esophagectomy for the esophageal carcinoma. The reconstructed\nstomach tube overlapped with the left medial segment of the liver and the\nhepatoduodenal ligament and was extensively and strongly adhered to them.\nIt is important for clinicians to know how to perform the detachment procedure\nsuccessfully in order to secure a surgical field for liver resection without\ndamaging the fragile reconstructed gastric tube. In order to avoid vascular injury\nof the stomach tube, it was decided that detachment around the hepatoduodenal\nligament preceded detachment of the stomach tube from the liver.\nAfter complete separation of the hepatoduodenal ligament from the stomach\ntube, the hepatoduodenal ligament was encircled with tape. Subsequently, adhesiolysis\nwas performed between the stomach tube and the liver. Finally, parenchymal\ntransection was performed using the intermittent hepatic inflow\nocclusion and crush clamping techniques to dissect the parenchyma. The patient\nwas discharged two weeks after surgery without complication.
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