Annals of Surgical Oncology

, Volume 16, Issue 7, pp 1843–1843

Systematic Subsegmentectomy by Ultrasound-Guided Finger Compression for Hepatocellular Carcinoma in Cirrhosis

  • Guido Torzilli
  • Matteo Donadon
  • Matteo Cimino
  • Daniele Del Fabbro
  • Fabio Procopio
  • Florin Botea
Multimedia Article

DOI: 10.1245/s10434-009-0457-x

Cite this article as:
Torzilli, G., Donadon, M., Cimino, M. et al. Ann Surg Oncol (2009) 16: 1843. doi:10.1245/s10434-009-0457-x

Abstract

Background

Systematic and extensive use of intraoperative ultrasound (IOUS) allows us to perform new conservative surgical procedures in liver surgery. This video shows systematic subsegmentectomy by IOUS-guided finger compression for a case of hepatocellular carcinoma (HCC) in cirrhosis.

Methods

The case of a 69-year-old woman with a single 3.5-cm HCC in segment 3 is presented. The patient has hepatitis C virus (HCV)-related well-compensated cirrhosis. After performing a T-inverted laparotomy, the IOUS is carried out for staging. Then, the area of resection is anatomically marked by IOUS-guided finger compression of the subsegmental portal branch feeding the tumor in segment 3. Thus, the resection is performed under intermittent Pringle maneuver using Pean-clasia and bipolar forceps.

Results

Ninety-day mortality and morbidity for this patient were nil. No blood transfusions were required. The patient was discharged 8 days after surgery.

Conclusions

Systematic subsegmentectomy by IOUS-guided finger compression is a feasible and effective technique, especially for HCC in cirrhosis. It may be potentially applied in each segment of liver as long as the thickness of the parenchyma and the anatomy of liver are suitable. We believe that this technique should be part of the modern liver surgeon’s armamentarium.

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Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Guido Torzilli
    • 1
  • Matteo Donadon
    • 1
  • Matteo Cimino
    • 1
  • Daniele Del Fabbro
    • 1
  • Fabio Procopio
    • 1
  • Florin Botea
    • 1
  1. 1.Liver Surgery Unit, Third Department of SurgeryUniversity of Milan School of Medicine, IRCCS Istituto Clinico HumanitasRozzano, MilanItaly