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Surgery Today
Published in: Surgery Today 12/2017

01-12-2017 | How to Do It

Left hepatectomy after right paramedian sectoriectomy

Authors: Takeshi Takamoto, Takuya Hashimoto, Masatoshi Makuuchi

Published in: Surgery Today | Issue 12/2017

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Abstract

Repeat hepatectomy is beneficial for selected patients with recurrence of liver malignancies. However, the operative procedure becomes technically demanding when the previous hepatectomy was complex, with hepatic veins and stump of portal pedicles exposed on the liver transection surface. We performed left hepatectomy after right paramedian sectoriectomy (RPMS) for three patients. Here, we describe our surgical technique and the postoperative outcomes achieved. This procedure allowed for safe adhesiolysis between the middle and right hepatic veins by following a fibrous plane. The mean operative time was 8.7 h, including 4.9 h of adhesiolysis. The mean remnant liver volume (right lateral sector and the caudate lobe) was calculated as 704 ml, being 62% of total liver volume. There was no postoperative liver failure or mortality. In conclusion, left hepatectomy after RPMS is a feasible procedure for patients with sufficient remnant liver volume, even though the middle and right hepatic veins run side by side after liver regeneration.
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Metadata
Title
Left hepatectomy after right paramedian sectoriectomy
Authors
Takeshi Takamoto
Takuya Hashimoto
Masatoshi Makuuchi
Publication date
01-12-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 12/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-017-1561-3

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