New technique for a safersegment VIII liver resection

Abstract

Colorectal cancer is one of the leading causes of death worldwide. Approximately 70% of patients with colorectal cancer will develop liver metastasis (LM). Hepatic resections are considered the gold standard treatment and can cure the disease. The preservation of a suitable future liver remnant is the most relevant factor to prevent postoperative liver failure and mortality. However, in certain situations parenchymal sparing surgery may be challenging in view of the location of metastasis, such as, for example, near the confluence of the hepatic veins. The goal of this technical note is to describe a new approach for segmental or subsegmental resection of the VIII, used in surgery to remove LM in segment VIII involving the middle hepatic vein. During resection of the node in segment VIII, the surgeon places the left index finger in the space created between the right hepatic vein and the trunk formed by the middle and left hepatic vein near the vena cava, and between the liver and the IVC thus creating a safe zone for parenchymal division. This technique allows a safer sparing liver resection of segment VIII.