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J Gastrointest Surg. 2013 Jun;17(6):1153-60. doi: 10.1007/s11605-012-2130-0. Epub 2013 Jan 29.

Clinical feasibility of inferior right hepatic vein-preserving trisegmentectomy 5, 7, and 8 (with video).

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1
Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Ludlow Faculty Research Building, 50 Yonsei-ro, Seodaemoon-gu, Seoul, 120-752, Korea.

Abstract

BACKGROUND AND AIM:

Hepatic resection involves not only complete removal of tumors but also preservation of optimal liver function after surgery. This study introduces the technique of inferior right hepatic vein (IRHV)-preserving trisegmentectomy 5, 7, and 8 and evaluates its clinical feasibility.

METHODS:

Between January 2008 and December 2011, four patients underwent this procedure. Postoperative outcomes and interim results were evaluated.

RESULTS:

The median estimated volumes of the left lobe only and the left lobe plus preserved parenchyma relative to the total estimated liver volume were 22.8 % (range, 21.1-24.2 %) and 43.6 % (range, 38.0-47.5 %), respectively. The median total operating time and blood loss were 349 min (range, 348-417 min) and 650 ml (range, 300-1,700 ml), respectively. One patient developed the postoperative complication of bile leakage. The median hospital stay was 14.5 days (range, 14-50 days). Median follow-up was 23.5 months (range, 6-70 months), and two patients developed recurrence. One patient died of disease progression, and the other three patients were alive at the last follow-up.

CONCLUSION:

Based on our experience, IRHV-preserving trisegmentectomy 5, 7, and 8 is a safe and feasible procedure. This technique could be an option for curative resection minimizing postoperative deterioration of liver function without preoperative portal vein embolization in patients with a reliable IRHV.

PMID:
23358844
DOI:
10.1007/s11605-012-2130-0
[Indexed for MEDLINE]
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