Anatomical subsegmentectomy in the lateral segment for hepatocellular carcinoma

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Liver Transplantation

Background:

• Chronic liver disease and hepatocellular carcinoma (HCC) pose significant surgical challenges.
• Anatomical liver resections are complex, especially in cirrhotic patients.
• Preservation of remnant liver function is crucial for patient outcomes.

Purpose of the Study:

• To describe a safe technique for anatomical subsegmentectomies of liver segments 2 and 3.
• To evaluate the outcomes of this technique in patients with HCC and chronic liver disease.
• To assess the impact on remnant liver function and potential for future HCC treatment.

Main Methods:

• Development and application of a novel technique for subsegmentectomy of segments 2 and 3.
• Detailed description of pedicle dissection and parenchymal transection.
• Application in six patients with HCC (four segment 3, two segment 2).

Main Results:

• The described technique was performed safely in all six patients.
• No postoperative liver failure occurred, with adequate remnant liver function.
• Three patients experienced HCC recurrence, but further treatments were feasible.

Conclusions:

• Anatomical subsegmentectomies of segments 2 and 3 can be safely performed using this technique, even in cirrhotic patients.
• The technique contributes to the preservation of remnant liver function.
• This approach facilitates future management of HCC recurrence.