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Diaphragmatic hernia following liver resection: case series and review of the literature
Ann Hepatobiliary Pancreat Surg 2017 Aug;21(3):114-21
Published online August 31, 2017
Copyright © 2017 Ann Hepatobiliary Pancreat Surg.

Francesco Esposito1, Chetana Lim1, Chady Salloum1, Michael Osseis1, Eylon Lahat1, Philippe Compagnon1,2, and Daniel Azoulay1,2

1Department of Hepatobiliary and Pancreatic Surgery and Liver Transplantation, Henri Mondor Hospital, Créteil, 2INSERM, U955, Créteil, France
Received March 21, 2017; Revised May 30, 2017; Accepted June 4, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Backgrounds/Aims: Postoperative diaphragmatic hernia, following liver resection, is a rare complication. Methods:Data of patients who underwent major hepatectomy for liver tumors, between 2011 and 2015 were retrospectively reviewed. The literature was searched for studies reporting the occurrence of diaphragmatic hernia following liver resection. Results: Diaphragmatic hernia developed in 2.3% of patients (3/131) with a median delay of 14 months (4-31 months). One patient underwent emergency laparotomy for bowel obstruction and two patients underwent elective diaphragmatic hernia repair. At last follow-up, no recurrences were observed. Fourteen studies including 28 patients were identified in the literature search (donor hepatectomy, n=11: hepatectomy for liver tumors, n=17). Diaphragmatic hernia was re-paired emergently in 42.9% of cases and digestive resection was necessary in 28.5% of the cases. One patient died 3 months after hepatectomy, secondary to sepsis, from a segment of small bowel that perforated into the diaphragmatic hernia. Conclusions: Although rare, diaphragmatic hernia should be considered as an important complication, especially in living donor liver transplant patients. Diaphragmatic hernia should be repaired surgically, even for asymptomatic patients. (Ann Hepatobiliary Pancreat Surg 2017;21:114-121)
Keywords : Diaphragmatic hernia; Liver resection; Repair; Systematic review