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Right trisegmentectomy for hepatic neoplasms

T E Starzl, L J Koep, R Weil

    Surgery, Gynecology & Obstetrics
    |February 1, 1980
    PubMed
    Summary
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    Right trisegmentectomy for liver tumors showed a 3.3% operative mortality and no late hepatic insufficiency. Over half of primary malignant tumor patients were tumor-free at 12 months, with better outcomes in children.

    Area of Science:

    • Hepatobiliary Surgery
    • Surgical Oncology
    • Liver Transplantation

    Background:

    • Primary hepatic tumors and liver metastases pose significant treatment challenges.
    • Surgical resection is a key modality for managing liver malignancies.
    • Trisegmentectomy offers a potential approach for extensive liver resections.

    Purpose of the Study:

    • To evaluate the safety and efficacy of right trisegmentectomy for various liver lesions.
    • To assess the oncologic outcomes following trisegmentectomy for primary and metastatic liver cancers.
    • To identify factors influencing patient outcomes after hepatic resection.

    Main Methods:

    • Retrospective analysis of 30 patients undergoing right trisegmentectomy.
    • Inclusion of primary hepatic malignant tumors, liver metastases, and benign lesions.

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  • Technical refinement involving intrahepatic identification and control of the right hepatic vein.

    • Main Results:

    • Operative mortality was 3.3%, with no observed late hepatic insufficiency.
    • Tumor-free status at 12 months was achieved in over 50% of primary malignant tumor patients.
    • Outcomes were superior in children compared to adults, and for primary tumors versus metastases.

    Conclusions:

    • Right trisegmentectomy is a viable procedure for selected liver lesions with acceptable morbidity and mortality.
    • The technical refinement of controlling the right hepatic vein facilitates resection of challenging tumors.
    • Adjuvant chemotherapy may be considered, though further research is needed to support its combined use with hepatic resection.