Bisegmentectomy 7-8 as alternative to more extensive liver resections

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Colorectal cancer management

Background:

• Preserving liver parenchyma is crucial to minimize liver failure risk and enable re-resection of recurrent tumors.
• Lesions in segments 7-8 invading the right hepatic vein typically necessitate a right hepatectomy.
• An alternative approach, bisegmentectomy 7-8, may be feasible when the inferior right hepatic vein is thick.

Purpose of the Study:

• To evaluate the safety and efficacy of bisegmentectomy 7-8 for liver tumors.
• To assess the oncologic outcomes and complications associated with this uncommon liver resection technique.

Main Methods:

• Retrospective review of patients undergoing bisegmentectomy 7-8 for colorectal liver metastases.
• Analysis of patient demographics, tumor characteristics, surgical outcomes, and survival data.

Main Results:

• Bisegmentectomy 7-8 was performed in 6 out of 332 patients with colorectal liver metastases involving segments 7-8 and the right hepatic vein.
• The mean remnant liver volume was 23.7%, with no postoperative liver failure or in-hospital mortality.
• Median survival was 25 months, with negative surgical margins achieved in all cases.

Conclusions:

• Bisegmentectomy 7-8 is a safe and effective procedure for selected patients.
• This technique allows for curative resection while conserving functional liver parenchyma.
• It provides an alternative to more extensive hepatectomies, improving patient outcomes.