• 대한수의학회지
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• 제7권1호
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• pp.8-18
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• 1967

Casting specimens of portal system and hepatic vein system in livers were made by injection of vinylite into the portal vein and postcava in 20 adult dogs. The author classificated the ramification of portal system and hepatic vein system. The results obtained were summerized as follows: 1. Portal system in livers were divided into left and right trunks. The left trunk subdivided into papillary process (caudate lobe,) left medial lobe, left lateral lobe, quadrate lobe and right medial lobe rami. The right trunk were subdivided into right lateral lobe and caudate proccss(caudate lobe.) 2. The lateral superior and medial inferior rami of portal system in left lateral lobe were subdivided 1 or 2 branches from left trunk. 3. The lateral superior ramus of portal system in left medial lobe did not appeared in 40% of the cases examined. 4. Portal system in quadrate lobe were subdivided 1-3 branches from left trunk, 5. Portol system in right medial lobe rami were relatively simple in ramification. 6. The lateral superior and medial inferior rami of portal system in right lateral lobe were subdivided 1 or 2 branches from right trunk. 7. Hepatic vein system of left lateral, left medial, quadrate and right medial lobe rami were originated from same ramus divided from the postcava in all cases. 8. Hepatic vein system of left and right rami in right medial lobe were divided from postcava.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.25-33
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• 2024

Backgrounds/Aims: Parenchymal-sparing anatomical hepatectomy (Ps-AH) based on portal ramification of the right anterior section (RAS) is a new technique to avoid unnecessarily transecting too much liver parenchyma, especially in cases of major anatomical hepatectomy. Methods: We prospectively assessed 26 patients with primary hepatic malignancies having undergone major Ps-AH based on portal ramification of the RAS from August 2018 to August 2022 (48 months). The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated. Results: Among the 26 patients analyzed, there was just one case that had intrahepatic cholangiocarcinoma The preoperative level of α-Fetoprotein was 25.2 ng/mL. All cases (100%) had Child-Pugh A liver function preoperatively. The ventral/dorsal RAS was preserved in 19 and 7 patients, respectively. The mean surgical margin was 6.2 mm. The mean surgical time was 228.5 minutes, while the mean blood loss was 255 mL. In pathology, 5 cases (19.2%) had microvascular invasion, and in the group of HCC patients, 92% of all cases had moderate or poor tumor differentiation. Six cases (23.1%) of postoperative complications were graded over III according to the Clavien-Dindo system, including in three patients resistant ascites or intra-abdominal abscess that required intervention. Conclusions: Parenchymal-sparing anatomical hepatectomy based on portal ramification of the RAS to achieve R0-resection was safe and effective, with favorable short-term outcomes. This technique can be used widely in clinical practice.