Central Bisectionectomy for Centrally Located Hepatocellular Carcinoma

ABSTRACT

PURPOSE: We wanted to analyzed the safety and the results of central bisectionectomy for treating patients with hepatocellular carcinoma. METHODS: Fourteen HCC patients who underwent central bisectionectomy were retrospectively reviewed. RESULTS: Eleven men and 3 women were included, and their mean age was 53 years old. Ten patients had HBV hepatitis. The indocyanine green retention rate at 15 minutes (ICG-R15) was 8.5 %. The mean operation time was 386 minutes, and the mean amount of intraoperative bleeding was 2150 ml. The mean weight of the resected liver was 304 gm. The mean size of tumor was 4.7 cm, and 11 patients had single tumor. The tumor stage was II in 7 patients, III in 5, and IV in 2, respectively. Seven patients(50%) suffered postoperative complications, there were 5 biliary complications (35.7%), such as biloma and bile leakage, two cases of pleural effusion(14.3%), two cases of ascites (14.3%), and one cases of liver failure due to necrosis of the remained right liver. Postoperative mortality occurred for 1 patient at the 70th postoperative day due to necrosis of the residual liver and liver failure. Recurrence was noted have occurred in 4 patients. The median follow period was 23 months (range12~89 months). CONCLUSIONS: Central bisectionectomy can be is safely performed in selected patients for treating centrally located HCC. However, it is necessary to understand the biliary and vascular anatomy and to preserve the vascular supply to the residual liver.