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Extended Mesohepatectomy with S6 and V6 Intrahepatic Vascular Reconstruction: Case Report

谢 于
Published: 1 January 2021

Abstract: 中肝切除是肝脏手术中间较困难的一种方式,通常中肝切除指S4、S5+8或S4+5+8段的切除,鲜有合并S7段的中肝切除。在合并S7段的扩大中肝切除时,需要保留S6段有独立且完整的回流静脉。本文报道1例肝肿瘤侵犯S4+5+8段、S7段、RHV、中肝静脉(middle hepatic vein, MHV),且S6段回心血流在根部有癌栓浸润患者,行保留肝脏S2、S3、S6段,联合下腔静脉癌栓取出并部分IVC切除,同时将保留的S6肝静脉与IVC再次吻合的手术经过。 Mesohepatectomy is a difficult method in liver surgery. Generally, mesohepatectomy refers to the resection of S4, S5+8 or S4+5+8 segments, but rarely combines with S7 segment hepatectomy. In the mesohepatectomy combined with S7 segment, it is necessary to keep an independent and complete draining vein for S6 segment. This article reports a case of hepatocarcinoma invading S4+5+8 segment, S7 segment, RHV, middle hepatic vein (MHV), and one of draining vein for S6 segment which flows into inferior RHV is filled with tumor thrombus. In this patient we performed extended mesohepatectomy, removed the IVC tumor thrombus and partial IVC, and re-anastomosed the remaining S6 hepatic vein to IVC.

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