From mesohepatectomy to mini-mesohepatectomy: Evolving the concept of resectability of hepatic tumors at the hepatocaval confluence

Research output: Contribution to journalArticle

Abstract

In the case of tumors in contact with or invading the middle hepatic vein (MHV) at the hepatocaval confluence, extended right hepatectomy or mesohepatectomy is usually recommended. Major or extended hepatectomy is associated with significant rates of morbidity and mortality, and a more conservative approach would be desirable. Thus, we developed a new conservative operation, the so-called mini-mesohepatectomy that, in some specific circumstances, allowed the en-bloc resection of segment 8, segment 4-sup and the MHV at the hepatocaval confluence and at the same time preservation of the remaining parenchyma of the right anterior section and left median section drained by the MHV. The present work describes the rationale, indications, as well as the surgical technique of this new operation which we believe should be part of the armamentarium of the modern hepatic surgeon, and will probably limit the need for a formal mesohepatectomy.

Original languageEnglish
Pages (from-to)109-113
Number of pages5
JournalDigestive Surgery
Volume28
Issue number2
DOIs
Publication statusPublished - Apr 2011

Keywords

  • Hepatic resection
  • Hepatic tumors
  • Hepatocaval confluence
  • Intraoperative ultrasound
  • Mesohepatectomy
  • Middle hepatic vein
  • Mini-mesohepatectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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