Right anterior sectionectomy for hepatocellular carcinoma with glissonean pedicle approach

Abstract

Hepatocellular carcinoma (HCC) is a common primary liver malignancy in Vietnam with a high mortality rate. Right anterior sectionectomy with selective control approach is preferred to the right or the central hepatectomies for HCC, in cirrhotic livers in order to preserve functional liver parenchyma. We carried out a retrospective analysis to evaluate the feasibility and safety of the right anterior sectionectomy at the Vietnam National Cancer Hospital. A retrospective descriptive study was conducted at Vietnam National Cancer Hospital from March 2017 to March 2020. The right anterior sectionectomy study group consisted of 47 patients. The mean patient age was 56.7 years. Of the 47 patients with HCC enrolled in the study, 91.5% were male. Cirrhosis (70.2%) and Hepatitis B virus (HBV) (74.5%) were the predominant chronic liver diseases. Most of the patients had normal preoperative liver function (Child-Pugh A, 97.9%, and MELD scores < 9, 89.4%). The median blood loss was 200 ± 120 mL. There were no intraoperative or postoperative transfusions given. The mean operation time was 182.23 ± 54.07 minutes (min - max: 80 – 340 minutes)(min; max). The median postoperative hospital stay was 7.52 ± 2.25 days (min – max: 5 – 21 days) (min; max). Posthepatectomy liver failure occurred in one case, and there was no perioperative mortality. After a median follow-up time of 33 months, the mean disease-free survival was 37.9 ± 1.9 months. 1-, 2- and 3-year survival rates were 94.7%, 92.1% and 85.0%, respectively.