OBJECTIVE: To assess the technical and oncologic results of anatomic hepatic bi- and trisegmentectomies. SUMMARY BACKGROUND DATA: Regardless of their size, some tumors require extensive hepatectomy only because they are located centrally or in the vicinity of major portal pedicles or hepatic veins. Anatomic bi- and trisegmentectomy might represent an alternative to extensive hepatectomies in such cases. METHODS: Of 435 liver resections, 32 cases (7%) included 2 or 3 adjacent segments (left lateral sectionectomies, ie, bisegmentectomies 2-3, excluded). There were 16 central hepatectomies (segments 4, 5, and 8), 7 right posterior sectionectomies (segments 6 and 7) and 2 central anterior (segments 4b and 5), 1 central posterior (segments 4a and 8), 2 right superior (segments 7 and 8), 3 right inferior (segments 5 and 6), and 1 left anterior (segments 3 and 4b) bisegmentectomies. Indications were malignant disease in 29 patients, including 15 with cirrhosis and 2 with benign tumors. External landmarks, selective devascularization, and intraoperative ultrasound were used to achieve anatomic resection. RESULTS: Mortality, transfusion, and morbidity rates were 0%, 26%, and 19%, respectively. Mean section margin was 9 mm (range, 1-40 mm). Isolated intrahepatic recurrence occurred in 7 patients (24%) and 3 (43%) underwent repeat hepatectomy. CONCLUSION: Anatomic bi- or trisegmentectomy is a safe alternative to extensive liver resection in selected patients, avoiding unnecessary sacrifice of functional parenchyma and enhancing the opportunity to perform repeat resections in cases of recurrence.
OBJECTIVE: To assess the technical and oncologic results of anatomic hepatic bi- and trisegmentectomies. SUMMARY BACKGROUND DATA: Regardless of their size, some tumors require extensive hepatectomy only because they are located centrally or in the vicinity of major portal pedicles or hepatic veins. Anatomic bi- and trisegmentectomy might represent an alternative to extensive hepatectomies in such cases. METHODS: Of 435 liver resections, 32 cases (7%) included 2 or 3 adjacent segments (left lateral sectionectomies, ie, bisegmentectomies 2-3, excluded). There were 16 central hepatectomies (segments 4, 5, and 8), 7 right posterior sectionectomies (segments 6 and 7) and 2 central anterior (segments 4b and 5), 1 central posterior (segments 4a and 8), 2 right superior (segments 7 and 8), 3 right inferior (segments 5 and 6), and 1 left anterior (segments 3 and 4b) bisegmentectomies. Indications were malignant disease in 29 patients, including 15 with cirrhosis and 2 with benign tumors. External landmarks, selective devascularization, and intraoperative ultrasound were used to achieve anatomic resection. RESULTS: Mortality, transfusion, and morbidity rates were 0%, 26%, and 19%, respectively. Mean section margin was 9 mm (range, 1-40 mm). Isolated intrahepatic recurrence occurred in 7 patients (24%) and 3 (43%) underwent repeat hepatectomy. CONCLUSION: Anatomic bi- or trisegmentectomy is a safe alternative to extensive liver resection in selected patients, avoiding unnecessary sacrifice of functional parenchyma and enhancing the opportunity to perform repeat resections in cases of recurrence.
Authors: Y Nakajima; S Ko; T Kanamura; M Nagao; H Kanehiro; M Hisanaga; Y Aomatsu; N Ikeda; H Nakano Journal: J Am Coll Surg Date: 2001-03 Impact factor: 6.113
Authors: M Minagawa; M Makuuchi; G Torzilli; T Takayama; S Kawasaki; T Kosuge; J Yamamoto; H Imamura Journal: Ann Surg Date: 2000-04 Impact factor: 12.969
Authors: M M Bilimoria; G Y Lauwers; D A Doherty; D M Nagorney; J Belghiti; K A Do; J M Regimbeau; L M Ellis; S A Curley; I Ikai; Y Yamaoka; J N Vauthey Journal: Arch Surg Date: 2001-05
Authors: S Suzuki; T Sakaguchi; Y Yokoi; K Kurachi; K Okamoto; T Okumura; Y Tsuchiya; T Nakamura; H Konno; S Baba; S Nakamura Journal: Surgery Date: 2001-04 Impact factor: 3.982
Authors: Thomas K Gallagher; Albert C Y Chan; Ronnie T P Poon; Tan To Cheung; Kenneth S H Chok; See Ching Chan; Chung Mau Lo Journal: HPB (Oxford) Date: 2012-11-21 Impact factor: 3.647
Authors: Dimitrios Moris; Sean Ronnekleiv-Kelly; Amir A Rahnemai-Azar; Evangelos Felekouras; Mary Dillhoff; Carl Schmidt; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-03-31 Impact factor: 3.452