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

Authors
 Sung Hoon Choi  ;  Gi Hong Choi  ;  Dai Hoon Han  ;  Jin Sub Choi  ;  Woo Jung Lee 
Citation
 JOURNAL OF GASTROINTESTINAL SURGERY, Vol.17(6) : 1153-1160, 2013 
Journal Title
JOURNAL OF GASTROINTESTINAL SURGERY
ISSN
 1091-255X 
Issue Date
2013
MeSH
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
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.
Full Text
https://link.springer.com/article/10.1007%2Fs11605-012-2130-0
https://link.springer.com/article/10.1007%2Fs11605-012-2130-0
DOI
10.1007/s11605-012-2130-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Seung Hoon(최승훈)
Choi, Jin Sub(최진섭)
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165965
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