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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 
 Journal of Gastrointestinal Surgery, Vol.17(6) : 1153-1160, 2013 
Journal Title
 Journal of Gastrointestinal Surgery 
Issue Date
Adult ; Aged ; Anastomosis, Surgical/adverse effects ; Anastomotic Leak/etiology ; Bile Duct Neoplasms/surgery* ; Bile Ducts, Intrahepatic/surgery* ; Blood Loss, Surgical ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Cholangiocarcinoma/surgery ; Colorectal Neoplasms/secondary ; Colorectal Neoplasms/surgery ; Contrast Media ; Feasibility Studies ; Female ; Hepatectomy/methods* ; Hepatic Veins/surgery* ; Humans ; Length of Stay ; Liver Neoplasms/diagnosis ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multidetector Computed Tomography ; Operative Time ; Organ Sparing Treatments*/adverse effects ; Positron-Emission Tomography ; Retrospective Studies
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
이우정(Lee, Woo Jung) ORCID logo https://orcid.org/0000-0001-9273-261X
최기홍(Choi, Gi Hong) ORCID logo https://orcid.org/0000-0002-1593-3773
최승훈(Choi, Seung Hoon)
최진섭(Choi, Jin Sub)
한대훈(Han, Dai Hoon) ORCID logo https://orcid.org/0000-0003-2787-7876
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