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Related Experiment Videos

Hepatic subsegmentectomy with segmental hepatic vein sacrifice.

M Beppu1, T Fukuzaki, K Mitani

  • 1Department of Surgery, Nishinomiya Prefectural Hospital, Japan.

Archives of Surgery (Chicago, Ill. : 1960)
|September 1, 1990
PubMed
Summary

Sacrificing major hepatic veins during liver subsegmentectomies for hepatocellular carcinoma is safe and feasible. This technique expands surgical options, enabling curative resections in challenging cases without compromising liver function.

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Area of Science:

  • Hepatobiliary surgery
  • Surgical oncology
  • Liver anatomy

Background:

  • Partial Budd-Chiari syndrome and hepatic vein ligation in trauma do not cause clinical disorders.
  • Major hepatic veins can potentially be sacrificed during liver resections.
  • Hepatocellular carcinoma often requires precise surgical resection.

Purpose of the Study:

  • To investigate the safety and efficacy of hepatic subsegmentectomies involving the sacrifice of major hepatic veins.
  • To assess the impact on postoperative liver function compared to standard resections.
  • To determine if this approach enables resection in previously unresectable cases.

Main Methods:

  • Performed hepatic subsegmentectomies sacrificing major hepatic veins in nine patients with hepatocellular carcinoma.

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  • Resected segments included S7, S8, and S5, with sacrifice of the right or middle hepatic veins.
  • Compared postoperative liver function tests with a control group undergoing standard segmentectomies/subsegmentectomies.

    • Main Results:

    • All nine hepatic subsegmentectomies were performed successfully without postoperative complications.
    • No significant differences in postoperative liver function tests were observed compared to the control group.
    • Resection was enabled in three cases and curative resection in six cases.

    Conclusions:

    • Sacrificing major hepatic veins during hepatic subsegmentectomy is a safe and viable surgical technique.
    • This approach expands the possibilities for liver resection, particularly for hepatocellular carcinoma.
    • It offers a method to achieve curative resection in selected cases without adversely affecting liver function.