Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Ultrasound-guided finger compression in liver subsegmentectomy for hepatocellular carcinoma

  • 156 Accesses

  • 27 Citations


Systematic subsegmentectomy is now accepted as the best option for the surgical management of hepatocellular carcinoma in patients with cirrhosis because it optimizes the balance between oncological requirements and the need to spare functioning liver parenchyma. However, this technique can be difficult because it requires a strong background in ultrasound-guided interventional procedures. We describe a new, simplified technique for the anatomical subsegmental hepatic resection of segment 2 or 3. It consists of IOUS-guided blunt portal branch compression to disclose the subsegmental area to be removed. This technique is a further evolution of so-called systematic subsegmentectomy for tumors located in segments 2 and 3. Its main advantages are that it is easy, fast, and reversible. We believe that it has the potential to lead to new opportunities in subsegmental anatomic liver resection.

This is a preview of subscription content, log in to check access.

Figure 1
Figure 2
Figure 3
Figure 4


  1. 1

    H Imamura Y Matsuyama Y Miyagawa K Ishida R Shimada S Miyagawa M Makuuchi S Kawasaki (1999) ArticleTitlePrognostic significance of anatomical resection and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma. Br J Surg. 86 1032–1038 Occurrence Handle10.1046/j.1365-2168.1999.01185.x Occurrence Handle1:STN:280:DyaK1MzptVagsg%3D%3D Occurrence Handle10460639

  2. 2

    M Makuuchi H Hasegawa S Yamazaki (1985) ArticleTitleUltrasonically guided subsegmentectomy. Surg Gynecol Obstet 161 346–350

  3. 3

    JM Regimbeau R Kianmanesh O Farges F Dondero A Sauvanet J Belghiti (2002) ArticleTitleExtent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma. Surgery 131 311–317 Occurrence Handle10.1067/msy.2002.121892 Occurrence Handle11894036

  4. 4

    G Torzilli M Makuuchi (2001) ArticleTitleUltrasound-guided liver subsegmentectomy: the peculiarity of segment 4. J Am Coll Surg 193 706–708 Occurrence Handle10.1016/S1072-7515(01)01077-8 Occurrence Handle1:STN:280:DC%2BD38%2Fkt12ntQ%3D%3D Occurrence Handle11768689

  5. 5

    G Torzilli M Makuuchi K Inoue T Takayama Y Sakamoto Y Sugawara K Kubota A Zucchi (1999) ArticleTitleNo-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: is there a way? A prospective analysis of our approach. Arch Surg 134 984–992 Occurrence Handle1:STN:280:DyaK1MvhsFGgtw%3D%3D Occurrence Handle10487594

Download references

Author information

Correspondence to G. Torzilli.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Torzilli, G., Makuuchi, M. Ultrasound-guided finger compression in liver subsegmentectomy for hepatocellular carcinoma. Surg Endosc 18, 136–139 (2004).

Download citation


  • Ultrasonography
  • Intraoperative ultrasonography
  • Hepatocellular carcinoma
  • Liver tumors
  • Cirrhosis