Τίτλος:
Extrahepatic right portal vein ligation allows parenchyma-sparing en
bloc resection of segments 7,8 and 4a for liver tumors engaging the
right and middle hepatic veins
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Right trisectionectomy for posterior liver tumors engaging the right and
middle hepatic veins may lead to post-hepatectomy liver failure if the
anticipated liver remnant is small. In such patients we developed a
parenchyma-sparing one-step approach, that includes extrahepatic right
portal vein ligation accompanied by en bloc resection only of segments
7, 8 and 4a and resection of the right and middle hepatic veins. The
technique was applied in 3 patients with normal liver function, where
according to the preoperative computed tomography the volume of segments
1, 2 and 3 ranged between 17% and 20% of the total liver volume. In
all patients liver biochemistry improved rapidly postoperatively and a
doubling of volume of segments 1,2 and 3 was achieved by the third
postoperative week, as extrahepatic right portal vein ligation
ameliorated reperfusion injury of the remaining segments 5 and 6 and
induced hypertrophy of segments 1, 2, 3 and 4b. There was no mortality
or long-term complications. Patients are alive and free of disease 74,
50 and 17 months after the operation, respectively. We propose that the
term “extended upper right sectionectomy” may be considered for the
en bloc resection of segments 7,8 and 4a, in future revisions of the
Brisbane 2000 terminology of hepatic anatomy and resections.
Συγγραφείς:
Farantos, Charalampos
Arkadopoulos, Nikolaos
Vassiliu, Pantelis
and Kokoropoulos, Panagiotis
Economopoulos, Nikolaos
Pandazi,
Aggeliki
Smyrniotis, Vassilis
Περιοδικό:
Hepatobiliary & Pancreatic Diseases International
Εκδότης:
ZHEJIANG UNIV SCH MEDICINE
Λέξεις-κλειδιά:
liver trisectionectomy; extrahepatic right portal vein ligation;
parenchyma-sparing hepatectomy
DOI:
10.1016/S1499-3872(15)60421-0
