Total or partial anatomical resection of segment 8 using the ultrasound-guided finger compression technique

Abstract

BackgroundA new surgical technique to define intra-operatively segmental and subsegmental areas of the liver using ultrasound-guided bimanual liver compression has been recently described. However, this technique does not allow disclosure of the subsegmental ventral (S8v) and dorsal (S8d) portions of segment 8 (S8). Another technique that overcomes these limitations is described. MethodsSix patients with hepatoma, cirrhosis and no evidence of portal vein thrombosis were submitted to the procedure. Demarcation of the resection area was achieved using ultrasound-guided finger compression of the S8 subsegmental portal branches (P8v and P8d). ResultsThe procedure was feasible in all patients and demarcation was always obtained within 1min of bimanual ultrasound-guided compression. In one patient, the entire S8 was resected. In the remaining five patients, the dorsal (four patients) or the ventral (one patient) portion was removed, respectively. There was no mortality or morbidity and no blood transfusions were administered. ConclusionsDisclosure of the subsegmental portions of S8 using the ultrasound-guided compression technique was feasible, safe and effective, and represents the completion of the ultrasound-guided compression technique for performing segmental and subsegmental anatomical resection of the liver.Description of a technique that allows delineation of subsegmental portions of segment 8 using ultrasound guided finger compression