Abstract
Postoperative hepatic failure preceded by insufficient remnant liver function is one of the major causes of mortality. The aim of this article was to present the usefulness of preoperative three-dimensional volumetric analysis applied in liver resection to avoid congestion in the remnant liver. The patient was a 45-year-old man with hilar cholangiocarcinoma. After bilateral percutaneous biliary transhepatic drainage, left hepatic lobectomy combined with total caudectomy was planned. Large inferior right hepatic vein (IRHV) and middle right hepatic vein (MRHV) was demonstrated by multidetector row computed tomography. By analyzing with liver simulation software, total liver volume and the remnant volume were 2,519.6 and 1,849.3 cm(3), respectively. The drainage volume of each vein was as follows: middle hepatic vein = 337.5 cm(3) (18.7%, ratio to the remnant right lobe); right hepatic vein = 627.9 cm(3) (34.8%); MRHV = 187.0 cm(3) (10.4%); IRHV = 651.9 cm(3) (36.1%). If we dissect both MRHV and IRHV, 46.5% of the remnant liver becomes congested. We planned to preserve these two veins. Operation was successfully performed without congestion. This modality provides a precise image of the intrahepatic structure and enables us to evaluate the congested area. This is important for a patient with a marginal amount of remnant liver, in which even a small congestion leads to a fatal consequence.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.