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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2017; 23(26): 4815-4822
Published online Jul 14, 2017. doi: 10.3748/wjg.v23.i26.4815
Published online Jul 14, 2017. doi: 10.3748/wjg.v23.i26.4815
Extreme liver resections with preservation of segment 4 only
Silvio Marcio Pegoraro Balzan, Marcelo Arbo Magalhães, Marcelo Luiz Dotto, Department of Pharmacy and Biology, University of Santa Cruz do Sul, 96810-110 Santa Cruz do Sul, Brazil
Silvio Marcio Pegoraro Balzan, Vinícius Grando Gava, Department of Surgery, Hospital Moinhos de Vento, 90035 Porto Alegre, Brazil
Author contributions: Balzan SMP, Gava VG and Magalhães MA designed the research, treated the patients, collected and analyzed the data, and wrote the paper; Dotto ML treated the patients and wrote the paper; all authors read and approved the final version for publication.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Hospital Ana Nery.
Conflict-of-interest statement: All authors declare no conflict of interest in relation to this study or its publication.
Data sharing statement: Technical appendix, statistical code and dataset are available from the corresponding author at sbalzan@hotmail.com. The data were anonymized and, thus, informed consent was not required from the participants.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Silvio Marcio Pegoraro Balzan, PhD, Department of Pharmacy and Biology, University of Santa Cruz do Sul, Rua Marechal Deodoro, 1139, 96810-110 Santa Cruz do Sul, Brazil. silviobalzan@unisc.br
Telephone: +55-51-37152824 Fax: +55-51-37152824
Received: January 29, 2017
Peer-review started: February 8, 2017
First decision: March 16, 2017
Revised: May 3, 2017
Accepted: June 9, 2017
Article in press: June 12, 2017
Published online: July 14, 2017
Peer-review started: February 8, 2017
First decision: March 16, 2017
Revised: May 3, 2017
Accepted: June 9, 2017
Article in press: June 12, 2017
Published online: July 14, 2017
Core Tip
Core tip: Extreme hepatic resections with preservation of one segment only may be required for complete resection of multiple bilobar liver metastases. We evaluated a new technique of two-stage hepatectomy with preservation of segment 4 only. Stage one involves a right hepatectomy with middle hepatic vein preservation and associated left lobe congestion through reduction of the left hepatic vein diameter. This combination optimizes segment 4 regeneration while allowing the left lobe (to be resected) to maintain function with reduced hypertrophy. Stage two involves a left lobectomy. Hypertrophy rates of non-congested segment 4 were significantly greater than in congested left lobe.