Extended left hepatectomy--modified operation planning based on three-dimensional visualization of liver anatomy.
BACKGROUND
Based on the patient history of a 62-year-old man with a centrally located hepatocellular carcinoma we describe the potential influence of three-dimensional computed tomography (3D CT) on operation planning in extended left hepatectomy.


RESULTS
By 3D reconstruction of the liver, not only variations of the intrahepatic vascular structure but also the number and extent of portal venous segments, as well as their relation to hepatic veins, can be visualized. Thus, areas at risk for either devascularization or venous congestion may be identified prior to liver resection. This is particularly important in extended hepatectomies with a small liver remnant, where already minor complications may have fatal consequences.


CONCLUSIONS
In these resections, operation planning may be improved substantially by pre-operative 3D reconstruction.
Lang
Hauke
H
Klinik für Allgemein- und Transplantationschirurgie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen, Germany. hauke.lang@uni-essen.de
Radtke
Arnold
A
Liu
Chao
C
Frühauf
Nils R
NR
Peitgen
Heinz O
HO
Broelsch
Christoph E
CE
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface