Segment VI/VII segmentectomy

Formal hepatic resection for hepatocellular carcinoma with a cirrhotic liver



01:30  Incision & MOBILIZATION

03:47  Portal dissection

06:57  Transection & closing


Case description
  • 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.
CT scans

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Pathology slides