How Far Can We Go with Laparoscopic Liver Resection for Hepatocellular Carcinoma? Laparoscopic Sectionectomy of the Liver Combined with the Resection of the Major Hepatic Vein Main Trunk

Figure 12

Preoperative CT findings (a) and intraoperative findings after completion of the resection (b), case 2 (left medial sectionectomies combined with middle hepatic vein resection). 70-year-old man with type-C chronic hepatitis developed 7.5 cm HCC in segment 4–8. (a) The tumor compressed the Glissonian pedicle widely, from hilar plate to umbilical plate and to anterior branch, and also there was an involvement of the middle hepatic vein (arrow head). This patient underwent extended left medial sectionectomy combined with the middle hepatic vein resection. (b) After completion of liver resection, the Glissonian pedicle, from hilar plate to umbilical plate and to anterior branch, was exposed and the stump of middle hepatic vein (arrow head) was clearly shown in the operative field.

(a)

(b)