| Title : The clinical study of precise hemihepatectomy guided by middle hepatic vein - Qiu_2012_World.J.Surg_36_2428 |
| Author(s) : Qiu Y , Zhu X , Zhu R , Zhou J , Zhou T , Wang Y , Ding Y |
| Ref : World J Surg , 36 :2428 , 2012 |
| Abstract : OBJECTIVE This study was designed to analyze the feasibility of classification for hepatic veins preoperatively and to evaluate the safety and therapeutic efficacy of precise hemihepatectomy guided by middle hepatic vein METHODS Thirty patients who underwent precise hemihepatectomy PH group were subjected to multi-slice helical CT hepatic venography preoperatively to achieve Nakamura's and Kawasaki's classification of hepatic veins The hemihepatectomy was performed precisely by the guidance of middle hepatic vein which was revealed by the hepatic venography and confirmed with intraoperative ultrasound The clinical data of these patients were compared with other 38 traditional hemihepatectomy patients control group The amount of intraoperative bleeding and blood transfusion liver function recovery postoperative complications and 1-year follow-up data were compared between two groups RESULTS The ratios of Nakamura's classification type I II and III of hepatic veins were 56.7 17/30 26.7 8/30 and 16.7 5/30 respectively The percentages of Kawasaki's classification type I and II of hepatic veins were 36.7 11/30 and 63.3 19/30 respectively The total 30 cases of precise hemihepatectomies were performed successfully including 13 cases of right hemihepatectomy without MHV 15 cases of left hemihepatectomy without MHV 1 case of right hemihepatectomy with MHV and 1 case of left hemihepatectomy with MHV There was no significant difference in operation-related mortality the amount of intraoperative bleeding and blood transfusion as well as serum alanine aminotransferase total bilirubin and cholinesterase of the third postoperative day between the two groups However negative resection margin and albumin level were more favorable in precise hemihepatectomy group than control group In addition the incidence of postoperative pleural effusion and seroperitoneum was decreased significantly in precise hemihepatectomy group The 1-year tumor-free survival rate was 79 15/19 In PH group which is 48 in control group CONCLUSIONS Preoperative evaluation of hepatic veins is of great value for individual operative program via determination of anatomical type of hepatic veins Precise hemihepatectomy could preserve functional liver tissue with complete venous return to a great extent resulting in fewer incidences of postoperative pleural effusion and seroperitoneum Precise hemihepatectomy also has the potential to achieve more adequate tumor-free resection margin which may result in higher tumor-free survival rate. |
| ESTHER : Qiu_2012_World.J.Surg_36_2428 |
| PubMedSearch : Qiu_2012_World.J.Surg_36_2428 |
| PubMedID: 22714574 |
Qiu Y, Zhu X, Zhu R, Zhou J, Zhou T, Wang Y, Ding Y (2012)
The clinical study of precise hemihepatectomy guided by middle hepatic vein
World J Surg
36 :2428
Qiu Y, Zhu X, Zhu R, Zhou J, Zhou T, Wang Y, Ding Y (2012)
World J Surg
36 :2428