ArticleAnnals of surgical oncology2026
Double Mini Upper Transversal Hepatectomy for Colorectal Liver Metastases Infiltrating the Right and the Left Hepatic Veins at the Hepatocaval Confluence.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatients with tumor infiltration of both the right hepatic vein (RHV) and left hepatic vein (LHV) at the caval confluence traditionally are considered unresectable. Presence of peripheral communicating veins (CVs) allows the resection of these tumors through an innovative parenchyma-sparing strategy
resultsIntraoperative ultrasound confirmed MHV patency and adequate drainage from segments 3 and 6 via CVs. R0 resection of segment 2 (with LHV division) and segments 7-8 (with RHV division) was performed under ultrasound guidance and IVC clamping. The MHV was preserved, ensuring venous outflow of the FLR. Post-resection doppler ultrasound confirmed adequate inflow and outflow. No major postoperative complications occurred, and the patient was discharged on postoperative (PO) day 12.
conclusionsAn innovative parenchyma-sparing resection is described: double mini upper transversal hepatectomy. This procedure can be performed when both RHV and LHV confluences are involved and CVs are present. Preservation of a single major hepatic vein supplemented by CV drainage can achieve oncologic radicality while sparing functional reserve.
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