Hepatic Subsegmentectomy With Segmental Hepatic Vein Sacrifice

• There is no clinical disorder in partial Budd-Chiari syndrome or in a major hepatic vein ligation in hepatic trauma. When considering these findings, it is significant to investigate hepatic subsegmentectomies in which a major hepatic vein is sacrificed. We performed such hepatic subsegmentectomies in nine cases of hepatocellular carcinoma. With the sacrifice of the right hepatic vein, S₇, S₈ resection was done in three patients, S₇ resection in two patients, S₈ resection in one patient, and S₅ resection in one patient. With the sacrifice of the middle hepatic vein, S₈ resection was done in two patients. These resections were successfully performed with no postoperative problem. Further, there were no significant differences in postoperative liver function tests of the patients from those of a control group of the commonly performed systematic segmentectomy and subsegmentectomy. By performing such resections, resection was made possible in three cases and curative resection was made feasible in six cases.

(Arch Surg. 1990;125:1170-1175)