Precise hepatectomy following important liver vessels for hepatobiliary tumors

Abstract

Objective To investigate the application value of precise hepatectomy following important liver vessels for hepatobiliary tumors. Methods Clinical data of 26 patients with hepatobiliary tumors in the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2013 were analyzed retrospectively. There were 14 males and 12 females with the age ranging from 20 to 66 years old and a median of 56 years old. The informed consents of all patients were obtained and local ethical committee approval had been received. The important vessels closely adjacenting to tumors were selected as the guide line for dissection according to the preoperative imaging examinations and intraoperative exploration results and the liver resecting surface was predicted. The anatomic relations between the tumor and the important liver vessels such as portal branch, hepatic vein, inferior vena cava were defined by intraoperative ultrasound. Precise hepatectomy were performed with surgical instruments such as cavitron ultrasonic surgical aspirator, bipolar coagulator. Results The operations of 26 patients were performed successfully and the tumors were resected completely, including left hemihepatectomy + caudate lobectomy (n=7), right hemihepatectomy (n=6), mesohepatectomy (n=4), extended right hemihepatectomy (n=3), segment Ⅳb, V hepatectomy (n=2), hepatic right anterior lobectomy (n=2), left hemihepatectomy + caudate lobectomy + pancreaticoduodenectomy (n=1), caudate lobectomy + artificial vessel replacement of retrohepatic inferior vena cava (n=1). The average operative time was (5.3±0.4) h, the intraoperative blood loss was (580±59) ml and the length of hospital stay was (19±3) d. No severe complications such as massive haemorrhage, liver failure were observed after operation. Abdominal infection was observed in 2 cases and biliary leakage in 1 case after operation and all were cured by anti-infection and drainage treatments. Conclusion Precise hepatectomy following the important liver vessels is a safe and effective surgical procedure for hepatobiliary tumors. Key words: Liver neoplasms; Bile ducts, intrahepatic; Hepatectomy