AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
Powered by AMiner. Clicking this button will take you away from SciOpen.
Home iLIVER Article
Article Link
Cite
EndNote(RIS) BibTeX
Collect
Submit Manuscript
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Original Article | Open Access

Right hepatectomy with preservation of segment VI: Seven cases of preliminary experience

Shounan Lua, Zhilei Sub, Zongrui Yangc, Sheng Taic( )
Department of Minimally Invasive Hepatic Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Department of Hepatic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Show Author Information

Abstract

Background

Surgical treatment of tumors near the center of the liver is challenging. Right hemihepatic or triple resection is considered the preferred approach, but it is associated with a high mortality rate due to postoperative liver failure. Therefore, attempts should be made to preserve liver parenchyma to the maximum extent possible. Segment VI of the liver is often excised "innocently". This article aims to discuss the experience of the right hemihepatectomy with the segment VI preserved.

Case presentation

The clinical medical records of 7 patients with right lobe liver cancer who underwent right hemihepatectomy with segment VI preservation during 2015–2021 were collected to selectively reconstruct the right hepatic vein to ensure liver blood return at segment VI.

Conclusions

Right hemihepatectomy with segment VI preservation can preserve more liver parenchyma and is a safe and reliable surgical method for patients who need to preserve more liver parenchyma.

Keywords

Liver cancerSegment VIHepatic vein reconstructionLiver failureIRHV

References

[1]

Alejandro F, María R, Jordi B. Hepatocellular carcinoma. Lancet 2018;391: 1301–14. https://doi.org/10.1016/S0140-6736(18)30010-2.
Crossref Google Scholar
[2]

Palavecino M, Chun YS, Madoff DC, et al. Major hepatic resection for hepatocellular carcinoma with or without portal vein embolization: perioperative outcome and survival. Surgery 2009;145: 399–405. https://doi.org/10.1016/j.surg.2008.10.009.
Crossref Google Scholar
[3]

Okabe H, Beppu T, Ishiko T, et al. Preoperative portal vein embolization (PVE) for patients with hepatocellular carcinoma can improve resectability and may improve disease-free survival. J Surg Oncol 2011;104: 641–6. https://doi.org/10.1002/jso.21928.
Crossref Google Scholar
[4]

Denys A, Lacombe C, Schneider F, et al. Portal vein embolization with N-butyl cyanoacrylate before partial hepatectomy in patients with hepatocellular carcinoma and underlying cirrhosis or advanced fibrosis. J Vasc Intervent Radiol 2005;16: 1667–74. https://doi.org/10.1097/01.RVI.0000182183.28547.DC.
Crossref Google Scholar
[5]

Veronica C, Alice T, Simone DF, Francesco D, Matilde T, Giorgio S. Tumor and its microenvironment: a synergistic interplay. Semin Cancer Biol 2013;23: 522–32. https://doi.org/10.1016/j.semcancer.2013.08.007.
Crossref Google Scholar
[6]

Hamady ZZ, Rees M, Welsh FK, et al. Fatty liver disease as a predictor of local recurrence following resection of colorectal liver metastases. Br J Surg 2013;100: 820–6. https://doi.org/10.1002/bjs.9057.
Crossref Google Scholar
[7]

Virginia H, Sara T, Scott LF, Josep ML. Role of the microenvironment in the pathogenesis and treatment of hepatocellular carcinoma. Gastroenterology 2013; 144: 512–27. https://doi.org/10.1053/j.gastro.2013.01.002.
Crossref Google Scholar
[8]

Asencio JM, Vaquero J, Olmedilla L, Sabrido JL García. "Small for-flow" syndrome: shifting the "size" paradigm. Med Hypotheses 2013;80: 573–7. https://doi.org/10.1016/j.mehy.2013.01.028.
Crossref Google Scholar
[9]

Truant S, Boleslawski E, Sergent G, et al. Liver function following extended hepatectomy can be accurately predicted using remnant liver volume to body weight ratio. World J Surg 2015;39: 1193–201. https://doi.org/10.1007/s00268-014-2929-9.
Crossref Google Scholar
[10]

Shindoh J, Truty MJ, Aloia TA, et al. Kinetic growth rate after portal vein embolization predicts posthepatectomy outcomes: toward zero liver-related mortality in patients with colorectal liver metastases and small future liver remnant. J Am Coll Surg 2013;216: 201–9. https://doi.org/10.1016/j.jamcollsurg.2012.10.018.
Crossref Google Scholar
[11]

Kishi Y, Abdalla EK, Chun YS, et al. Three hundred and one consecutive extended right hepatectomies: evaluation of outcome based on systematic liver volumetry. Ann Surg 2009;250: 540–8. https://doi.org/10.1097/SLA.0b013e3181b674df.
Crossref Google Scholar
[12]

Ronnie TPP, Sheung TF, Chung ML, Chi LL, John W. Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg 2002;235: 373–82. https://doi.org/10.1097/00000658-200203000-00009.
Crossref Google Scholar
[13]

Hayato A, Shintaro Y, Masamichi M, Tokio H, Tadatoshi T. Perfusion and drainage difference in the liver parenchyma: regional plane in segment 6. Biosci Trends 2014;11: 326–32. https://doi.org/10.5582/bst.2017.01063.
Crossref Google Scholar
[14]

Pierre-Alain C, Henrik P, Michelle LD, Rolf G. Strategies for safer liver surgery and partial liver transplantation. N Engl J Med 2007;356: 1545–59. https://doi.org/10.1056/NEJMra065156.
Crossref Google Scholar
[15]

van der Bilt JD, Soeters ME, Duyverman AM, et al. Perinecrotic hypoxia contributes to ischemia/reperfusion-accelerated outgrowth of colorectal micrometastases. Am J Pathol 2017;170: 1379–88. https://doi.org/10.2353/ajpath.2007.061028.
Crossref Google Scholar
[16]

Alan WH, Alan IR, Shiro F, Ivan Z, Richard JH, Robin DK. Role for extending hepatic resection using an aggressive approach to liver surgery. J Am Coll Surg 2008;206: 870–5. https://doi.org/10.1016/j.jamcollsurg.2007.12.036.
Crossref Google Scholar
[17]

Hwang S, Lee SG, Park KM, et al. Quilt venoplasty using recipient saphenous vein graft for reconstruction of multiple short hepatic veins in right liver grafts. Liver Transpl 2005;11: 104–7. https://doi.org/10.1002/lt.20314.
Crossref Google Scholar
[18]

Uchida K, Taniguchi M, Shimamura T, et al. Threedimensional computed tomography scan analysis of hepatic vasculatures in the donor liver for living donor liver transplantation. Liver Transpl 2010;16: 1062–8. https://doi.org/10.1002/lt.22109.
Crossref Google Scholar
[19]

Nakamura S, Tsuzuki T. Surgical anatomy of the hepatic veins and the inferior vena cava. Surg Gynecol Obstet 1981;152: 43–50.
Google Scholar
[20]

Sung HC, Gi HC, Dai HH, Jin SC, Woo JL. Clinical feasibility of inferior right hepatic vein-preserving trisegmentectomy 5, 7, and 8 (with video). J Gastrointest Surg 2013;17: 1153–60. https://doi.org/10.1007/s11605-012-2130-0.
Crossref Google Scholar
[21]

Xing X, Li H, Liu WG. Clinical studies on inferior right hepatic veins. Hepatobiliary Pancreat Dis Int 2007;6: 579–84.
Google Scholar
[22]
Sharma M, Sood D, Chauhan NS, Verma N, Kapila P. Inferior right hepatic vein on routine contrast-enhanced CT of the abdomen: prevalence and correlation with right hepatic vein size. Clin Radiol 2019;74. https://doi.org/10.1016/j.crad.2019.05.023. 735.e9-735.e14.
[23]

Hemming AW, Reed AI, Howard RJ, et al. Preoperative portal vein embolization for extended hepatectomy. Ann Surg 2003;237:686–91. https://doi.org/10.1097/01.SLA.0000065265.16728.C0.
Crossref Google Scholar
[24]

Cengizhan Y, Olivier F, Reza K, Jean-Marc R, Eddie KA, Jacques B. The small remnant liver after major liver resection: how common and how relevant? Liver Transpl 2003;9:S18–25. https://doi.org/10.1053/jlts.2003.50194.
Crossref Google Scholar
[25]

Azoulay D, Castaing D, Krissat J, et al. Percutaneous portal vein embolization increases the feasibility and safety of major liver resection for hepatocellular carcinoma in injured liver. Ann Surg 2000;232:665–6. https://doi.org/10.1097/00000658-200011000-00008.
Crossref Google Scholar
iLIVER
Volume 1 Issue 2,
June 2022
Pages 122-126
DOI: 10.1016/j.iliver.2022.04.003
Cite this article:
Lu S, Su Z, Yang Z, et al. Right hepatectomy with preservation of segment VI: Seven cases of preliminary experience. iLIVER, 2022, 1(2): 122-126. https://doi.org/10.1016/j.iliver.2022.04.003

458

Views

0

Crossref

Altmetrics
Received: 15 February 2022
Revised: 05 April 2022
Accepted: 05 April 2022
Published: 15 April 2022
© 2022 Published by Elsevier Ltd on behalf of Tsinghua University Press.

This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Return