Extended central hepatectomy with preservation of segment 6 for patients with centrally located hepatocellular carcinoma

Mahmoud Abdelwahab Ali, Jung Fang Chuang, Chee Chien Yong, Chih Chi Wang*, Chi Ying Lin, Chao Long Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

8 Scopus citations

Abstract

Background In order to preserve functional liver parenchyma, extended central hepatectomy (segments 4, 5, 7 and 8 resection) was proposed for the management of centrally located hepatocellular carcinoma invading the right and middle hepatic veins, reconstructing segment 6 outflow in the absence of the thick inferior right hepatic vein. The present study was to describe our surgical techniques of extended central hepatectomy. Methods Between 2008 and 2012, 5 patients with centrally located hepatocellular carcinoma invading or in the vicinity of the right and middle hepatic veins underwent extended central hepatectomy. The thick inferior right hepatic vein was preserved during dissection. Gore-Tex graft was used for segment 6 outflow reconstruction in the absence of the thick inferior right hepatic vein. Results The mean future remnant liver volume for segments 2 and 3 was 28% versus 45% on segment 6 preservation. The mean tumor diameter was 7.4 cm. The thick inferior right hepatic vein was found in 1 patient. Outflow reconstruction from segment 6 was performed in 4 patients. Postoperative complications included bile leakage (1 patient), pleural effusion (2) and liver failure (1). The rate of graft patency was 75%. There was no perioperative mortality. Conclusion Extended central hepatectomy is a safe alternative for extended hepatic resection in selected patients attempting to preserve the functional liver parenchyma.

Original languageEnglish
Pages (from-to)63-68
Number of pages6
JournalHepatobiliary and Pancreatic Diseases International
Volume14
Issue number1
DOIs
StatePublished - 01 02 2015

Bibliographical note

Publisher Copyright:
© 2015 The Editorial Board of Hepatobiliary & Pancreatic Diseases International.

Keywords

  • hepatectomy
  • hepatic vein thrombosis
  • hepatocellular carcinoma
  • liver cirrhosis
  • liver imaging

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