Central Lobectomy Using Balloon Catheters for the Hepatic Veins

Koji Okuda, Satoshi Taniwaki, Kazusaburo Ando, Kazuharu Shigetomi, Atsushi Matsumoto, Mikihisa Muta, Yuji Mada, Hideki Saitsu, Toshimichi Nakayama

Second Department of Surgery, Kurume University School of Medicine

We performed a central lobectomy on a patient with hepatocellular carcinoma. In addition to occlusion of the afferent vessels, to decrease intraoperative hemorrhage during hepatectomy, we occluded the right hepatic vein and middle hepatic vein at the hepatocval junction using balloon catheters inserted transhepaticaly under intraoperative ultrasonic guidance. The afferent vessels of the right lobe and the right hepatic vein were occluded during parenchymal resection along the right hepatic vein. Total inflow occlusion by Pringle's method and occlusion of the middle hepatic vein were performed during resection near the middle hepatic vein. The intraoperative bleeding volume was 1,100 ml, the postoperative maximum serum GOT level was 381. K.U. and the maximum serum bilirubin level was 2.3 mg/dl. This method should be useful for systematic resection along the hepatic vein or for the resection of a tumor located at the confluence of the hepatic vein.

Key words
hepatocellular carcinoma, occlusion of the hepatic vein, hepatic resection

Reprint requests
Koji Okuda Second Department of Surgery, Kurume University School of Medicine
67 Asahi-machi, Kurume, 830 JAPAN

Accepted
March 13, 1991

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