Anatomical polysegmentectomy with reservation of segments Ⅰ and Ⅳ for the treatment of complicated hepatolithiasis
10.3760/cma.j.issn.1673-9752.2011.02.023
- VernacularTitle:保留肝Ⅰ和Ⅳ段的解剖性多肝段切除治疗复杂型肝胆管结石
- Author:
Ding LUO
;
Deke QING
;
Jiang HAN
- Publication Type:Journal Article
- Keywords:
Hepatolithiasis;
Anatomical liver resection;
Portal pedicle
- From:
Chinese Journal of Digestive Surgery
2011;10(2):145-147
- CountryChina
- Language:Chinese
-
Abstract:
Anatomical hepatic segmentectomy is the treatment of choice for hepatolithiasis. However, in consideration of the volume of residual liver and the liver function, anatomical polysegmentectomy of the bilateral lobes for hepatolithiasis is restricted. Protection of the portal pedicles to the segments preserved and avoidance of ischemia/reperfusion injury to the residual liver parenchyma are critical steps during the operation.A female patient with hepatolithiasis and had a surgical history of choledocholithiasis removal and T-tube drainage received ana tomic polysegmentectomy with segments Ⅰ and Ⅳ preservation at the General Hospital of Kunming Medical College. During the operation, Portal pedicles to the segments Ⅰ , Ⅱ, right lobe,and segments Ⅱ and Ⅲ were isolated prior to liver parenchyma transection. Portal pedicles to segments Ⅰ and Ⅳ were protected under direct visualization. Hepatoduodenal ligament occlusion was not applied during liver parenchyma transaction. Segments Ⅱ- Ⅲ and Ⅴ-Ⅷ were anatomically resected, and segments Ⅰ ,Ⅳ were preserved with satisfactory vascularization. The patient recovered uneventfully and was discharged 14 days after the operation.
