A simple technique ligating the corresponding inflow and outflow vessels during anatomical left hepatectomy

Excerpt

First of all, the controlled method is inflow vessels ligation, obtaining the ischemic area, and then liver is divided in it. It means that although the right liver is resected, some liver parenchyma along the main portal fissure will be remained. Accordingly, the method is non-anatomical resection. It has been well known that tumor cells spread through the portal vein and forms intrahepatic metastasis in hepato-cellular carcinoma (HCC). Thus systematic subsegmentectomy procedure has been devised to remove all the liver parenchyma belonging to the ligated portal vein. The strict anatomical resection of the liver is the significant prognostic factor even in the multivariate analysis. Therefore, complete resection of the parenchyma belonging to the portal venous branch is recommended in patients with HCC. While Chen’s method is safe, fast, and the amount of bleeding is little, it may be considered as a non-anatomical resection due to the above-mentioned reasons. …