Ultrasound-Guided Conservative Heopatecomy for Tumors Invading the Middle Hepatic Vein at the Caval Confluence as Alternative to Mesohepatectomy and Trisectionectomy
Major hepatectomies have not negligible morbidity and mortality. However, when tumors invade
middle hepatic vein (MHV) at caval confluence trisectionectomy (TS) is generally performed,
and central hepatectomy or mesohepatectomy (MH) (Segments 4, 5 and 8), is considered by
some authors to be the conservative alternative to the previously cited approach. Between
these two surgical interventions there is not, up to now, any evidence that one of them
should be clearly preferred; anyway both are mojor resections. We previously reported that a
surgical approach based on ultrasound-guided hepatectomy might minimize the need for major
resection, whose rates of morbidity and mortality are not negligible. This policy could be
useful also for disclosing new, more conservative, and better tolerated approaches for
tumors invading the MHV at caval confluence in alternative to MH and TS. This study
analyses the feasibility, safety and effectiveness of ultrasound-guided resections applied
to these patients enrolled prospectively from a cohort of consecutive patients who undergo
hepatectomy for tumors.
Observational
Observational Model: Cohort, Time Perspective: Prospective
The primary outcome measure was the rate of failure of conservative resection, i.e. the rate of patients who received TSs or MHs despite they fitted in the eligibility criteria.
January 2007
No
Guido Torzilli, MD, PhD
Principal Investigator
University of Milan, Istituto Clinico Humanitas - IRCCS
Italy: Ministry of Health
HEP-MHV
NCT00600522
January 2004
May 2007
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