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Laparoscopic anatomic S4 segmentectomy for hepatocellular carcinoma
Keun Soo Ahn1, Ho-Seong Han, Yoo-Seok Yoon
1Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|August 23, 2011
Summary
Laparoscopic S4 segmentectomy is a feasible approach for selected hepatocellular carcinoma (HCC) cases, preserving liver volume. This minimally invasive technique offers a viable alternative to major liver resections for specific S4 segment tumors.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgical techniques
- Hepatocellular carcinoma management
Background:
- Segment 4 (S4) hepatocellular carcinoma (HCC) resection benefits from preserving left lateral segment volume.
- Standard left hemihepatectomy may be excessive for isolated S4 HCC.
- S4 segmentectomy offers a targeted approach to preserve liver parenchyma.
Observation:
- A 63-year-old male presented with an incidentally detected hepatic mass.
- Imaging revealed a 3.2 cm HCC in the superior S4 segment, contacting the middle hepatic vein.
- The patient had Child-Pugh class A liver function.
Findings:
- A total laparoscopic extended S4 segmentectomy was successfully performed.
- The procedure involved resection of the middle hepatic vein.
- Operative time was 440 minutes with 800 mL blood loss; no transfusion was required.
- The patient was discharged on postoperative day 10 with no complications.
Implications:
- Laparoscopic S4 segmentectomy is a feasible and safe option for select HCC patients.
- This approach minimizes liver volume loss compared to hemihepatectomy.
- Minimally invasive liver surgery advances HCC treatment strategies.
