Journal of Gastrointestinal Surgery

, Volume 17, Issue 6, pp 1153–1160 | Cite as

Clinical Feasibility of Inferior Right Hepatic Vein-Preserving Trisegmentectomy 5, 7, and 8 (with Video)

  • Sung Hoon Choi
  • Gi Hong Choi
  • Dai Hoon Han
  • Jin Sub Choi
  • Woo Jung Lee
How I do it

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.

Keywords

Liver Anatomy Resection Hepatectomy Inferior right hepatic vein 

Notes

Acknowledgments

The authors would like to express the special thanks to Dong-Su Jang (Medical Illustrator, Medical Research Support Section, Yonsei University College of Medicine, Seoul, Korea) for his help with the figures and Jee-Ye Kim (M.D., Department of Surgery, Yonsei University College of Medicine, Seoul, Korea) for her valuable devotion and contribution in preparing an English narration in the supplementary video stream.

Conflict of interest

Dr. Sung Hoon Choi, Gi Hong Choi, Dae Hoon Han, Jin Sub Choi, and Woo Jung Lee have no conflicts of interest or source of funding to disclose.

Supplementary material

ESM 1

(WMV 43514 kb)

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Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Sung Hoon Choi
    • 1
  • Gi Hong Choi
    • 1
  • Dai Hoon Han
    • 1
  • Jin Sub Choi
    • 1
  • Woo Jung Lee
    • 1
  1. 1.Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University Health SystemYonsei University College of MedicineSeoulKorea

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