Evidence map›Paper›PMID 42257742›Full record

ArticleSurgery today2026

Intraoperative doppler ultrasonography to assess the need for remnant liver fixation.

Toshiro Masuda, Toru Beppu, Tatsunori Miyata, Kenichiro Yoshida, Yuki Adachi, Kensuke Yamamura, Hirohisa Okabe, Hidetoshi Nitta, Katsunori Imai, Hiromitsu Hayashi and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Toshiro MasudaDepartment of Surgery, Yamaga City Medical Center, 511 Yamaga, Yamaga, 861-0593, Japan.ORCID http://orcid.org/0000-0003-4306-4277
Toru BeppuDepartment of Surgery, Yamaga City Medical Center, 511 Yamaga, Yamaga, 861-0593, Japan. tbeppu@yamaga-mc.jp.ORCID http://orcid.org/0000-0001-9046-0454
Tatsunori MiyataDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.ORCID http://orcid.org/0000-0003-4749-4741
Kenichiro YoshidaDepartment of Radiology, Yamaga City Medical Center, Yamaga, Japan.
Yuki AdachiDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.ORCID http://orcid.org/0000-0003-1915-0407
Kensuke YamamuraDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
Hirohisa OkabeDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.ORCID http://orcid.org/0000-0003-3041-7563
Hidetoshi NittaDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.ORCID http://orcid.org/0000-0002-1875-4789
Katsunori ImaiDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.ORCID http://orcid.org/0000-0003-0549-1825
Hiromitsu HayashiDepartment of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.ORCID http://orcid.org/0000-0002-1832-4287
Yasunori NagayamaDepartment of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.ORCID http://orcid.org/0000-0003-3280-7346
Takatoshi IshikoDepartment of Surgery, Yamaga City Medical Center, 511 Yamaga, Yamaga, 861-0593, Japan.ORCID http://orcid.org/0009-0002-6243-3525

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHepatic venous outflow block (HVOB) is a potentially serious complication after hepatectomy. Although routine anatomical fixation of the remnant liver is often advocated to prevent HVOB, its universal necessity remains controversial. We conducted this study to evaluate the utility of intraoperative Doppler ultrasonography for guiding selective remnant liver fixation.

methodsA total of 26 patients who underwent right-sided or central hepatectomy with transection of the falciform ligament between April 2016 and January 2025 were enrolled prospectively in this study. Intraoperative Doppler ultrasonography was used to assess venous flow in spontaneous and anatomical liver positions. Fixation using the round ligament, with or without the falciform ligament, was performed selectively when venous outflow impairment was observed.

resultsEight patients (31%) required fixation. Portal vein thrombosis occurred in five patients, including one with concurrent hepatic vein thrombosis caused by incorrect positioning. Apart from the illustrative case, all thrombotic events were asymptomatic and resolved with anticoagulation. Postoperative complications and liver regeneration were comparable between the groups. Postoperative abdominal discomfort was more frequent in the anatomical group, but the difference was not significant.

conclusionIntraoperative Doppler ultrasonography may facilitate on-demand remnant liver fixation by allowing real-time assessment of venous outflow impairment. This approach may help prevent complications and avoid unnecessary fixation.

Indexed as

Budd-Chiari SyndromeHepatectomyHepatic VeinsLiverPostoperative ComplicationsUltrasonography, DopplerAdultAgedFemaleHumansIntraoperative PeriodMaleMiddle AgedPortal VeinProspective StudiesVenous ThrombosisDoppler ultrasonographyHepatectomyHepatic venous outflow blockportal vein thrombosisRemnant liver fixation

Identifiers

PMID42257742

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.