A new guide technique for limited partial hepatectomy using a transhepatic tube.

In order to maintain the adequate tumor margin in partial hepatectomy, we developed a new guide technique using a fine transhepatic tube. For instance, in a case of anterior segment tumor, a fine needle following a tube was inserted into the liver beside the anterior portal pedicle at hepatic hilus, and was put forward to the confluence of right and middle hepatic veins. After the needle was pulled out, both edges of the tube were tugged to the Rex Cantlie line. A separation was then started from the liver surface down to the transhepatic tube. Subsequently, the tube was pulled to the right side, and another separation was done. Adequate disease-free surgical margins were kept in thirteen out of 15 various types of partial hepatectomies. There were no complications including injury to the vessels and stabbing of the tumor. This technique facilitates cutting of the deep parenchyma.