Function-preserving segmentectomy of the cirrhotic liver.
OBJECTIVE
A cirrhotic case of hepatocellular carcinoma (HCC) complicating portal vein tumor thrombi which underwent posterior segmentectomy with anterior portal venoplasty is reported.


METHODS
The HCC originated in the right posterior segment and grew intraluminally up to the right portal vein, and the laboratory data indicated a presence of severe cirrhosis. The operative procedure undertaken consisted of internal shunting of the portal blood stream by mesentero-umbilical bypass, resection of the posterior segment and the anterior portal venous root, and reconstruction of the anterior portal branch by patch grafting.


RESULTS
This operation produced no distinct complications, and it was defined pathologically as being curative.


CONCLUSIONS
The case here introduces rationale of this modified hepatic segmentectomy in view of functional preservation of the residual cirrhotic liver.
Takayama
T
T
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Nakatsuka
T
T
Shimada
K
K
Yamamoto
J
J
Kosuge
T
T
Yamasaki
S
S
Hirai
Y
Y
Makuuchi
M
M
D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery*; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome