[Mesohepatectomy-an alternative to extended hepatectomy in the treatment of central liver tumors].

Mesohepatectomy was performed in seven patients with a primary or secondary central liver tumor. We describe the surgical procedure for mesohepatectomy (removal of segments IVa/IVb/V/VIII +/- I) in the treatment of central hepatic tumors. This technically demanding but safe approach requires careful vascular dissection to maintain blood supply and venous drainage of the two remaining liver parts. Mesohepatectomy results in one or two large resection planes bearing a considerable risk of parenchymal necrosis or biliary leakage. Its major advantage over extended hepatectomy is the preservation of functioning liver tissue. Thus, the risk of postoperative liver failure is reduced and, in case of intrahepatic recurrence, the chance for repeat hepatectomy improved. Mesohepatectomy should be considered in selected cases of central liver tumors in which extended resection would be associated with a high risk of liver insufficiency.