title: Extended left hepatectomy by severing all major hepatic veins with reconstruction of the right hepatic vein.
abstract: Curative liver resection is technically challenging when multiple liver metastases from colon cancer involve the confluence of the three major hepatic veins. We report two cases of successful extended left hemihepatectomy achieved by severing all of the major hepatic veins together with the wall of the inferior vena cava, to resect liver metastases from colon cancer. Reconstruction of the right hepatic vein was done after unroofing the right anterior area of the liver with a direct anastomosis of the right hepatic vein. We did not need to perform total vascular exclusion or portovenous shunting during the liver transection. This simple and safe method can increase the surgical indications for previously unresectable tumors.
authors.affiliation: Department of Gastrointestinal Surgery, Cancer Institute Hospital, 1-37-1 Kami-Ikebukuro, Toshima-ku, Tokyo 170-8455, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Tomoo
authors.initials: T
authors.lastname: Kosuge
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Makoto
authors.initials: M
authors.lastname: Seki
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Kaoru
authors.initials: K
authors.lastname: Azekura
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Tetsuichiro
authors.initials: T
authors.lastname: Muto
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D002430:Cecal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D012811:Sigmoid Neoplasms / Q000473:pathology*; D014656:Vascular Surgical Procedures / Q000379:methods; D014682:Vena Cava, Inferior / Q000473:pathology