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World Journal of Surgery
Published in: World Journal of Surgery 4/2015

01-04-2015 | Original Scientific Report

Ventral Segment-Preserving Right Hepatectomy in Patients with Hepatocellular Carcinoma

Authors: Jin Hong Lim, Gi Hong Choi, Sung Hoon Choi, Hyung Soon Lee, Kyung Sik Kim, Jin Sub Choi

Published in: World Journal of Surgery | Issue 4/2015

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Abstract

Background

Transection along the anterior fissure was proposed as a mechanism by which to open the third door of the liver. In this study, we investigated surgical outcomes of a ventral segment-preserving right hepatectomy (VSPRH) compared with those of conventional right hepatectomy in patients with hepatocellular carcinoma (HCC).

Methods

Between January 2007 and December 2010, 595 primary HCC patients underwent liver resection at the authors’ institution. Among them, the 123 HCC patients who underwent a right hepatectomy were retrospectively analyzed. The patients were classified into two groups according to the type of resection: those who underwent a VSPRH (Group A; 27 cases) and those who underwent a conventional right hepatectomy (Group B; 96 cases).

Results

In Group A, expected remnant liver volume after a right hepatectomy was calculated to be 32.1 ± 7.2 % of functional total liver volume (FTLV); remnant liver volume increased up to 54.7 ± 7.2 % of FTLV after a VSPRH. Clinicopathologic characteristics and intraoperative data did not differ between the two groups. The liver-related complication rate was higher in Group B (P = 0.02). Overall survival and disease-free survival rates were similar (3-year disease-free survival (Group A: 67.8 %; Group B: 71.7 %; P = 0.65); 3-year overall survival (Group A: 91.7 %; Group B: 87.4 %; P = 0.26). In regard to long-term synthetic function, the 1-year postoperative serum albumin level was higher in Group A.

Conclusions

A VSPRH yielded fewer liver-related complications and similar long-term oncologic outcomes, compared with conventional right hepatectomy in cirrhotic patients with a small left lobe volume. Therefore, VSPRH can be considered to be an alternative procedure for a right hepatectomy.
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Metadata
Title
Ventral Segment-Preserving Right Hepatectomy in Patients with Hepatocellular Carcinoma
Authors
Jin Hong Lim
Gi Hong Choi
Sung Hoon Choi
Hyung Soon Lee
Kyung Sik Kim
Jin Sub Choi
Publication date
01-04-2015
Publisher
Springer US
Published in
World Journal of Surgery / Issue 4/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2894-3

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