Feasibility and safety of bisegmentectomy 7-8 while preserving hepatic venous outflow of the right liver - A retrospective cohort study
- Authors
- Jo, Hye-Sung; Yu, Young-Dong; Yoon, Kyung Chul; Kang, Woo-Hyoung; Kim, Dong-Sik
- Issue Date
- 7월-2020
- Publisher
- ELSEVIER
- Keywords
- Liver neoplasm; Hepatectomy; Hepatic veins; Surgical anastomosis
- Citation
- INTERNATIONAL JOURNAL OF SURGERY, v.79, pp.273 - 279
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF SURGERY
- Volume
- 79
- Start Page
- 273
- End Page
- 279
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/54871
- DOI
- 10.1016/j.ijsu.2020.05.075
- ISSN
- 1743-9191
- Abstract
- Background: When a hepatic tumor is deeply located in segments 7 and 8 around the right hepatic vein (RHV), right hemihepatectomy (RH) could be excessive owing to the resection of large tumor-free segments. This study aimed to evaluate the feasibility and safety of bisegmentectomy 7-8 (S7-8) and to compare its surgical outcomes with those of RH. Materials and methods: Consecutive patients who underwent S7-8 and RH were enrolled in this study. In the S7-8 group, 14 patients with an obvious inferior right hepatic vein (IRHV) (median: 6 mm; range: 3.6-8.8 mm) underwent S7-8 without hepatic vein reconstruction. RHV reconstruction was performed in six patients without an IRHV, involving direct anastomosis of the RHV in five patients and reconstruction using a cryo-preserved iliac vein in one patient. Results: A total of 61 patients were included (20 in S7-8 group; 41 in RH group). No significant differences were observed other than higher a model of end-stage liver disease score in the RH group than in the S7-8 group (7 [6-20] vs. 6 [6-9], P = 0.003). Post-hepatectomy liver failure including severe grades was more frequent in the RH group (43.9% vs. 10%, P = 0.008). In the S7-8 group, two patients with direct RHV reconstruction had RHV anastomosis obstruction, and eventually required insertion of a metallic scent. However, computed tomography performed 4 weeks after the operation showed intact venous outflow of the right liver in the S7-8 group. Conclusion: S7-8 can be performed safely in selected patients with a thick IRHV. For patients with no obvious IRHV, RHV reconstruction could be a good surgical strategy to retain venous outflow of the right liver with feasible outcomes.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
- Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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