title: Extended left hepatectomy of the left and middle hepatic venous drainage areas along the anterior fissure.
abstract: 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.
authors.affiliation: Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitonachou, Chuouku, Chiba, Japan. acho@chiba-cc.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Cho
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Kainuma
authors.forename: Matsuo
authors.initials: M
authors.lastname: Nagata
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takiguchi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimada
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Soda
authors.forename: Hisashi
authors.initials: H
authors.lastname: Gunji
authors.forename: Akinari
authors.initials: A
authors.lastname: Miyazaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ikeda
mesh_terms: 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