Digital Glissonectomy: A Safe Perihepatic Peritonectomy.

BACKGROUND: Complete cytoreductive surgery (CRS), combining organ resection and peritonectomy, is the only treatment that could offer cure for patients with peritoneal carcinomatosis. Initially, when the Glisson's capsule was involved without deep liver parenchyma invasion, either electroevaporation or Glisson's capsule resection was proposed. The objective of this study is to present and evaluate the safety of this standardized digital glissonectomy.

METHODS: Since 2009, the peritonectomy of the Glisson's capsule, or digital glissonectomy, has been standardized at our institution.

RESULTS: Among 655 patients who underwent a complete CRS between 2009 and 2014, 91 (14 %) glissonectomies were performed. Pseudomyxoma peritonei was the primary indication, and a glissonectomy was more frequently performed for patients with high peritoneal cancer index. The morbidity and mortality of CRS were not increased after glissonectomy (p = 0.069 and 0.949, respectively).

CONCLUSIONS: Digital glissonectomy is feasible and safe, when proposed for superficial deposits on Glisson's capsule.