title: Total or partial anatomical resection of segment 8 using the ultrasound-guided finger compression technique.
abstract: BACKGROUND
  A new surgical technique to define intra-operatively segmental and subsegmental areas of the liver using ultrasound-guided bimanual liver compression has been recently described. However, this technique does not allow disclosure of the subsegmental ventral (S8v) and dorsal (S8d) portions of segment 8 (S8). Another technique that overcomes these limitations is described.
  
  
  METHODS
  Six patients with hepatoma, cirrhosis and no evidence of portal vein thrombosis were submitted to the procedure. Demarcation of the resection area was achieved using ultrasound-guided finger compression of the S8 subsegmental portal branches (P8v and P8d).
  
  
  RESULTS
  The procedure was feasible in all patients and demarcation was always obtained within 1 min of bimanual ultrasound-guided compression. In one patient, the entire S8 was resected. In the remaining five patients, the dorsal (four patients) or the ventral (one patient) portion was removed, respectively. There was no mortality or morbidity and no blood transfusions were administered.
  
  
  CONCLUSIONS
  Disclosure of the subsegmental portions of S8 using the ultrasound-guided compression technique was feasible, safe and effective, and represents the completion of the ultrasound-guided compression technique for performing segmental and subsegmental anatomical resection of the liver.
authors.affiliation: Liver Surgery Unit, 3rd Department of Surgery, University of Milan - School of Medicine, IRCCS Istituto Clinico Humanitas - HUMANITAS CANCER CENTER, Razzano, Milan, Italy. guido.torzilli@unimi.it
authors.forename: Guido
authors.initials: G
authors.lastname: Torzilli
authors.forename: Fabio
authors.initials: F
authors.lastname: Procopio
authors.forename: Angela
authors.initials: A
authors.lastname: Palmisano
authors.forename: Matteo
authors.initials: M
authors.lastname: Donadon
authors.forename: Daniele
authors.initials: D
authors.lastname: Del Fabbro
authors.forename: Matteo
authors.initials: M
authors.lastname: Marconi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Scifo
authors.forename: Marco
authors.initials: M
authors.lastname: Montorsi
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery* / Q000821:virology; D006498:Hepatectomy; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery* / Q000821:virology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010173:Palpation; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional