Hepatic Subsegmentectomy (SVIII) for Hepatocellular Carcinoma Under Thoracolaparotomy with Right Diagonal Approach

Abstract

In Japan, because more than 90% of patients with hepatocellular carcinoma (HCC) are infected with the hepatitis C or B virus (HCV and HBV, respectively), their liver function is often poor. There have been some types of procedures for hepatic resection developed, such as lobectomy, seg-mentectomy, subsegmentectomy, and partial resection. Liver segmentectomy refers to resection of Couinaud’s sector and subsegmentectomy refers to resection of Couinaud’s segments. The choice between performing liver segmentectomy or larger and smaller resections is made on the basis of the patient’s liver function or the type of hepatitis virus with which the patient is infected. Because recurrence occurs from the primary tumor in patients with hepatitis B, larger systemic resection should be offered to those patients. In contrast, it has been reported that because synchronous or metachronous multicentric occurrence of the tumor is dominant in patients with hepatitis C, limited resection according to Glisson’s structures should be performed.¹