Ann Hepatobiliary Pancreat Surg.  2022 Aug;26(3):257-262. 10.14701/ahbps.21-159.

Influence of middle hepatic vein resection during right or left hepatectomy on post hepatectomy outcomes

• Nutu A
• Wilson M
• Ross E
• Joshi K
• Sutcliffe R
• Roberts K
• Marudanayagam R
• Muiesan P
• Chatzizacharias N
• Mirza D
• Isaac J
• Dasari BVM

• KMID: 2532642
• DOI: http://doi.org/10.14701/ahbps.21-159

Abstract

Backgrounds/Aims
Middle hepatic vein (MHV) is usually preserved as a part of the right or left hepatectomy in order preserve the venous outf low of remnant liver. The aim of this study was to evaluate if resection of MHV could inf luence post-resection outcomes of standard right or left hepatectomy.
Methods
Patients who underwent standard right or left hepatectomy between January 2015 and December 2019 were included. Anatomical remnant liver volumes were measured retrospectively using the Hermes workstation (Hermes Medical Solutions AB, Stockholm, Sweden). Uni- and multi-variate analyses were performed to assess the difference in outcomes of those with preservation of MHV and those without preservation.
Results
A total of 144 patients were included. Right hepatectomy was performed for 114 (79.2%) and left hepatectomy was performed for 30 (20.8%) patients. MHV was resected for 13 (9.0%) in addition to the standard right or left hepatectomy. Median remnant liver volume was significantly higher in the MHV resected group (p < 0.01). There was no significant difference in serum level of bilirubin, international normalized ratio, alanine aminotransferase, creatinine on postoperative day 1, 3, 5, or 10, ≥ grade IIIa complications (p = 0.44), or 90-day mortality (p = 0.41). On multivariable analysis, resection of the MHV did not inf luence the incidence of post hepatectomy liver failure (p= 0.52).
Conclusions
Resection of the MHV at standard right or left hepatectomy did not have a negative impact on postoperative outcomes of patients with adequate remnant liver volume.

Keyword

Hepatic vein; Liver; Surgery

Figure

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  Fig. 1 Correlation between specimen weight and calculated future liver remnant volume.

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