ArticleBMC surgery2020
Structure and surgical dissection layers of the bare area of the liver.
Article in BMC surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Effect of laparoscopic anatomical hepatectomy for hepatocellular carcinoma based on individualized three-dimensional reconstruction model of portal vein region.World journal of surgical oncology · 2026Article
- Computed tomography characteristics of hepatic involvement secondary to tuberculous peritonitis: a case series.Quantitative imaging in medicine and surgery · 2026Article
- Embryological, anatomical and clinical considerations on pleuroperitoneal communication.Pleura and peritoneum · 2023Review
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe bare area was reportedly formed by direct adhesion between the liver and diaphragm, meaning that the bare area lacked serosal components. This study aimed to analyze the structure of the bare area by an integrated study of surgical and laparoscopic images and pathological studies and describe surgical procedures focusing on the multilayered structure.
methodsSeveral surgical specimens of hepatectomy were analyzed histologically to evaluate the macroscopic structure of the bare area. Laparoscopic images and cadaver anatomy of the bare area were also examined.
resultsThe multilayered structure of the bare area comprised the liver, sub-serosal connective tissue, liver serosa, parietal peritoneum, retroperitoneal connective tissue, epimysium of the diaphragm, and diaphragm, in order from the liver to the diaphragm. The liver serosa and the parietal peritoneum fused with each other. This multilayered structure of the bare area is observed almost constantly. There are two layers in the dissection of the bare area in surgical procedures, an outer layer of the fused peritoneum (near the diaphragm) and an inner layer of the fused peritoneum (near the liver). Laparoscopic images enabled us to recognize the multilayered structure of the bare area.
conclusionsHistopathological findings showed the bare area to be a multilayered structure. In cases where tumors are located underneath the bare area, it could be important to dissect the bare area, with careful attention to its multilayered structure. Surgical dissection of the bare area in the outer layer of the fused peritoneum could allow a sufficient safety margin.
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