Segment VI/VII segmentectomy
Formal hepatic resection for hepatocellular carcinoma with a cirrhotic liver
00:09 SURGICAL PLANNING
01:30 Incision & MOBILIZATION
03:47 Portal dissection
06:57 Transection & closing
- The patient was a 74 year old woman with Child's A cirrhosis (likely on the basis of NASH) and an asymptomatic 4 cm hepatocellular carcinoma, identified during investigation of an unrelated problem.
- The bilirubin was 5 mmol/L , albumin was 40 g/L, INR was 1.03 and the platelet count was 340.
- The tumour was somewhat exophytic; it lay within segments VI & VII. Contrast-enchanced ultrasound confirmed the solitary lesion.
- Surgical resection is preferred over trans-arterial chemoembolization (TACE), radiation or Sorafenib. In the presence of cirrhosis, a parenchymal sparring procedure is preferred. Based on the relationship with the right hepatic vein, a formal resection of segment VI & VII was planned.