Hepatectomy preserving drainage veins of the posterior section for liver malignancy invading the right hepatic vein: an alternative to right hepatectomy.
BACKGROUND
Although a right hepatectomy (RH) traditionally has been performed for liver tumors infiltrating the main trunk of the right hepatic vein (RHV), the presence of drainage veins of the posterior section (DVPS) beside the RHV provides a chance to preserve their draining area even if the main trunk of the RHV is removed.


METHODS
Since 2005, we systematically have performed DVPS-preserving hepatectomies whenever possible. In the present study, we describe our experience treating 12 consecutive patients who underwent this procedure.


RESULTS
We performed the following types of liver resections concomitant with the main trunk of the RHV without packed red cell transfusion, liver failure, or 90-day mortality: extended right anterior sectionectomy in 2 patients, extended segmentectomy 7 in 3, extended segmentectomy 8 in 2, and partial resection of segment 7 in 2 and segment 8 in 3. Postoperative morbidity was observed in 4 (33%) cases, all of which had pleural effusion requiring a tap. A free resection margin was obtained in all patients.


CONCLUSIONS
This procedure could be a useful alternative to RH, providing a chance for radical liver resection with minimal parenchymal sacrifice in selected patients with DVPS.
First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Akira
A
Shimizu
Akira
A
Kobayashi
Takahide
T
Yokoyama
Takenari
T
Nakata
Hiroaki
H
Motoyama
Koji
K
Kubota
Norihiko
N
Furusawa
Hiroe
H
Kitahara
Noriyuki
N
Kitagawa
Kentaro
K
Fukushima
Tomoki
T
Shirota
Shinichi
S
Miyagawa
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D014056:Tomography, X-Ray; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional