Clinical analysis of right anterior segmentectomy for hepatic malignancy

Combined resection of segments 5 and 8, or right anterior segmentectomy, is one of the most difficult hepatic resections because of the danger of bleeding from the two major hepatic veins, the middle and right hepatic veins, during hepatectomy. We describe here the operative procedure and clinical a...

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Published inHepato-gastroenterology Vol. 53; no. 72; p. 836
Main Authors Kim, Ki Hun, Kim, Hee Sung, Lee, Young Joo, Park, Kwang Min, Hwang, Shin, Ahn, Chul Soo, Moon, Deok Bog, Ha, Tae Yong, Kim, Yeon Dae, Kim, Kun Kook, Song, Ki Won, Choi, Sang Tae, Kim, Dong Sik, Jung, Dong Hwan, Lee, Sung Gyu
Format Journal Article
LanguageEnglish
Published Greece 01.11.2006
Subjects
Carcinoma, Hepatocellular - surgery
Female
Hepatectomy - methods
Hepatic Veins - surgery
Humans
Liver - blood supply
Liver - surgery
Liver Neoplasms - surgery
Male
Middle Aged
Postoperative Complications - mortality
Retrospective Studies
Sepsis - mortality
Treatment Outcome
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Summary:Combined resection of segments 5 and 8, or right anterior segmentectomy, is one of the most difficult hepatic resections because of the danger of bleeding from the two major hepatic veins, the middle and right hepatic veins, during hepatectomy. We describe here the operative procedure and clinical analysis of right anterior segmentectomy in 35 patients with hepatic malignancy. Between March 1993 and December 2004, 35 patients underwent right anterior segmentectomy for hepatic malignancy. The technique used was based on the extraglissonian approach and parenchymal Kelly crushing, during which the two major hepatic veins were almost fully exposed. Thirty-three patients had hepatocellular carcinoma, one had peripheral cholangiocellular carcinoma, and one had primary hepatic sarcoma. The mean operation time was 331 +/- 73 minutes and the mean transfusion of packed RBC was 1.09 +/- 1.57 pints. There was one in-hospital death as a result of sepsis and hepatic failure. The cumulative 1-, 2- and 5-year survival rates were 94%, 72% and 62%, respectively. For surgeons who accurately know the anatomy of the liver, this procedure is safe and suitable in selected patients with hepatic malignancies and may increase the survival rate.
ISSN:0172-6390