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Preparatory hepatic resection with right hepatic vein reconstruction for paracaval liver tumor
Author(s) -
Kaneoka Yuji,
Yamaguchi Akihiro,
Isogai Masatoshi,
Harada Tohru,
Suzuki Masahiko
Publication year - 2002
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s005340200030
Subject(s) - medicine , resection , hepatocellular carcinoma , hepatectomy , surgery , blood loss , vein , posterior segment of eyeball , radiology
A liver tumor in the paracaval portion was very difficult to resect because of its anatomical situation. We therefore employed a technique using right hepatic vein (RHV) resection and reconstruction following the resection of segments VII/VIII with the paracaval portion. The patient was a 70‐year‐old man who had a hepatocellular carcinoma in the paracaval portion, and the root of the RHV was compressed by the tumor. Computed tomography (CT) during arterioportography under temporary balloon occlusion of the RHV demonstrated hypoattenuation of the entire posterior segment, meaning that RHV reconstruction following the resection of segments VII/VIII with RHV resection would be necessary. We performed the above‐mentioned operation without any trouble. On mobilizing segments VI/V to the caudal direction after dissecting the distal RHV, the paracaval Glissons were easily exposed and dissected anteriorly from the first order of the right Glissonean sheath. Our preliminary surgical technique, based on IVR‐CT, could provide a better surgical field and result in decreased operating time and decreased blood loss in paracaval liver malignancy.