Jia Changku1*, Weng Jie2, Qin Qifan3, Chen Youke2 and Fu Yu2
1Department of Hepatobiliary Pancreatic Surgery, Nanjing Medical University, China
2Department of Hepatobiliary Pancreatic Surgery, The Affiliated Hospital of Hainan Medical University, China
3Department of General Surgery, Lin’gao County Hospital of Hainan Province, China
Background: The patients with huge (≥10 cm) or multiple Hepatocellular Carcinoma (HCC) in right liver and insufficient volume of remnant left liver cannot be performed right hemihepatectomy in that liver failure will occur post operation. We designed anatomic trisegmentectomy in right liver to increase the percentage of future liver remnant volume (%FLRV), thus increasing the resectability of huge or multiple HCC.Methods: Thirteen patients were analysed by preoperative CT scan for liver and tumor volumetries. If right hemihepatectomy was performed, %FLRV would be at the range of 29.6% - 37.5%. However, if trisegmentectomy was done, %FLRV would increase by an average of 14.0%. So patients will not undergo postoperative liver failure due to sufficient %FLRV. Therefore, we designed anatomic trisegmentectomy, with retention of segment 5 or segment 8, to increase %FLRV and increase the resectability for huge or multiple HCC.Results: After trisegmentectomy, the inflow and outflow of remnant liver were maintained well. Severe complications and mortality was not happened post operation. Of the 13 patients, 10 survived up to now. Of the 10 living cases, postoperative lung metastasis was found in 2 and intra hepatic recurrence was found in 1. These 3 patients survive with tumor after comprehensive therapies including oral administration of Sorafenib.Conclusion: Compared to right hemihepatectomy, anatomic trisegmentectomy in right liver guarantees the maximum preservation of %FLRV to increase the resectability of huge or multiple HCC, thus improving the overall resection rate.
Anatomic segmentectomy; Hepatocellular carcinoma; Respectability; Liver volume
Changku J, Jie W, Qifan Q, Youke C, Yu F. Anatomic Trisegmentectomy: An Alternative Treatment for Huge or Multiple Hepatocellular Carcinoma of Right Liver. Clin Oncol. 2016; 1: 1147.