Hepatectomy of right superior portion (segment VII and VIII) combined with right hepatic vein reconstruction: a case report.
A 63-year-old man was admitted for the surgical treatment of hepatocellular carcinoma in the segment VIII. The tumor was 4 cm in size, and the major trunk of the right hepatic vein and a branch of the middle hepatic vein were compressed by the tumor on preoperative hepatic venogram. To preserve the remnant liver function, resection of segments VII and VIII combined with right hepatic vein reconstruction was attempted. Right hepatic vein was reconstructed using an autologous external iliac vein graft after resection of segments VII and VIII with the reason that the inferior right hepatic vein was small in this case and the congestive change was recognized on the surface of segment V and VI after temporary clamp of the right hepatic vein. The postoperative course was uneventful, and the grafted portion was patent on postoperative hepatic venogram. Postoperative pathological examination revealed that poorly differentiated hepatocellular carcinoma of 4 cm x 3.5 cm in size existed in the segment VIII, and directly infiltrated to the main trunk of the right hepatic vein. This is uncommon operative method, but may be useful for preservation of the remnant liver function.
Tsuji
Y
Y
Department of Surgery, Kobe University School of Medicine.
Sasada
A
A
Watanabe
Y
Y
Sugimoto
T
T
Ohkubo
T
T
Okada
M
M
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional