Segment VII/partial segment VIII liver resection for HCC
with Pringle manuever, facilitated by accessory segment VI hepatic vein
00:17 SURGICAL PLANNING
02:07 MOBILIZATION & EXPOSURE
03:37 DEFINING TRANSECTION MARGINS
04:53 PARENCHYMAL TRANSECTION
09:11 CLOSING
Case Description
- The patient is a 82 year old man, with a longstanding history of hepatitis B.
- CT scans revealed a mass in the segment 7 liver, which was later confirmed as hepatocellular carcinoma (HCC). Scans also revealed an anomalous accessory hepatic vein, which provided adequate outflow for segment 6.
- A segment 7, partial segment 8 resection was planned as surgical treatment. The surgical planes would divide the segment 7 pedicle, two portal vein branches that originate from the right anterior portal vein, as well as the right hepatic vein.
- Care is taken when approaching the antero-posterior surgical plane, to make sure the direction of transection is perpendicular to the liver surface, in order to prevent 'skiving', or deviation of the plane, ensuring the liver is transected beyond the tumor.
CT scans (arterial)
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CT scans (venous)
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