Safe Resection of Renal Cell Carcinoma with Liver Invasion Using Liver Hanging Technique Supported by Preoperative Portal Vein Embolization

Figure 3

Result of volumetric analysis by the Synapse Vincent Work Station ((a) before portal vein embolization (PVE), (b) after PVE, D: estimated liver volume) and intraoperative finding of the liver (c). In 3-dimensional graphics of (a) and (b), estimated resected liver is shown in green, estimated remnant liver is light brown, IVC and major veins are blue, portal vein is pink, and kidney is purple. The estimated resected tumor liver volume was 921 ml (71% of whole liver) at pre-PVE status (a). After PVE, estimated resected liver volume reduced to 599 ml (53.4% of whole liver) (b). Intraoperative findings showed morphologically shrunken right liver parenchyma (arrows show the midline) due to portal ischemia (c). Hanging tube is shown by dotted arrows. Total and estimated liver volume are shown (d).

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