Extended left hepatectomy of the left and middle hepatic venous drainage areas along the anterior fissure.
BACKGROUND
Extended left hepatectomy including the middle hepatic vein (MHV) may potentially induce right paramedian sector congestion of the remnant liver.


METHODS
To prevent venous congestion in the right paramedian sector, we performed extended left hepatectomy including the left hemiliver and anterior segment, which drain into the MHV and left hepatic vein (LHV), for 15 patients.


RESULTS
In 11 of 15 patients (73%), temporary clamping of the common trunk of the MHV and LHV and the proper hepatic artery provided the anterior fissure. Regeneration rate of the middle segment was similar to that of the right lateral sector (10.8% vs 11.2%) on postoperative computed tomography (CT) after 3 months.


CONCLUSIONS
This procedure could represent a useful method for preventing postoperative venous congestion.
Cho
Akihiro
A
Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba, Japan. acho@chiba-cc.jp
Yamamoto
Hiroshi
H
Kainuma
Osamu
O
Nagata
Matsuo
M
Takiguchi
Nobuhiro
N
Shimada
Hideaki
H
Soda
Hiroaki
H
Gunji
Hisashi
H
Miyazaki
Akinari
A
Ikeda
Atsushi
A
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006503:Hepatic Veins; D006801:Humans; D006940:Hyperemia / Q000209:etiology / Q000517:prevention & control*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome