Classification of right hepatectomy for special localized malignant tumor in right liver lobe.

AIM: To describe a new classification method of right hepatectomy according to the different special positions of tumors.

METHODS

According to positions, 91 patients with malignant hepatic tumor in the right liver lobe were divided into six groups: tumors in the right posterior lobe and (or) the right caudate lobe compressing the right portal hilum (n = 14, 15.4%), tumors in the right liver lobe compressing the inferior vena cava and (or) hepatic veins (n = 11, 12.9%), tumors infiltrating diaphragmatic muscle (n = 7, 7.7%), tumors in the hepatorenal recess (infiltrating the right fatty renal capsule, transverse colon and right adrenal gland, n = 8, 8.8%), tumors deeply located near the vertebral body (n = 3, 3.3%), tumors at other sites in the right liver lobe (the control group, n = 48, 52.75%). The values of intraoperative blood loss (IBL), tumor's maxim cross-section area (TMCSA), and time of hepatic hilum clamping (THHC) and incidence of postoperative complications were compared between five groups of tumor and control group, respectively.

RESULTS

The THHC in groups 1-4 was significantly longer than that in the control group, the IBL in groups 1-4 was significantly higher than that in the control group, the TMCSA in groups 2-4 was significantly larger than that in the control group, and the ratio of IBL/TMCSA in group 1 was significantly higher than that in the control group. There was no significant difference in the indexes between group 5 and the control group.

CONCLUSION

The site of tumor is the key factor that determines IBL.