• The close relationship of hepatic segment VIII to the right and middle hepatic veins and to the inferior vena cava makes liver cancer resection in this region extremely difficult. Resection of segment VIII was performed in 25 patients with primary liver cancer between January 1970 and May 1990. Most resections were performed with just porta hepatis occlusion, but some cases required the technique of total hepatic vascular exclusion, otherwise known as "bloodless hepatic resection." It involved control of both the suprahepatic and infrahepatic inferior vena cavae in addition to control of the porta hepatis. Major modifications to the original technique were made, and the 1-, 3-, and 5-year survival rates were 90.5%, 50.0%, and 37.5%, respectively. Two patients have survived 12 and 15 years, respectively. Both of them are alive to date and have returned to work.
(Arch Surg. 1993;128:224-227)