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BACKGROUND:?In? order? to? preserve? functional? liver? paren-chyma,?extended?central?hepatectomy?(segments?4,?5,?7?and?8?resection)?was?proposed?for?the?management?of?centrally?lo-cated?hepatocellular?carcinoma?invading?the?right?and?middle?hepatic?veins,?reconstructing?segment?6?outflow?in?the?absence?of?the?thick?inferior?right?hepatic?vein.?The?present?study?was?to?describe?our?surgical?techniques?of?extended?central?hepa-tectomy.
METHODS:?Between?2008?and?2012,?5?patients?with?centrally?located?hepatocellular?carcinoma?invading?or?in?the?vicinity?of? the? right? and? middle? hepatic? veins? underwent? extended?central?hepatectomy.?The?thick?inferior?right?hepatic?vein?was?preserved?during?dissection.?Gore-Tex?graft?was?used?for?seg-ment?6?outflow?reconstruction?in?the?absence?of?the?thick?infe-rior?right?hepatic?vein.
RESULTS:?The? mean? future? remnant? liver? volume? for? seg-ments?2?and?3?was?28%?versus?45%?on?segment?6?preservation.?The?mean?tumor?diameter?was?7.4?cm.?The?thick?inferior?right?hepatic?vein?was?found?in?1?patient.?Outflow?reconstruction?from? segment? 6? was? performed? in? 4? patients.? Postoperative?complications? included? bile? leakage? (1? patient),? pleural? effu-sion?(2)?and?liver?failure?(1).?The?rate?of?graft?patency?was?75%.?There?was?no?perioperative?mortality.
CONCLUSION:?Extended?central?hepatectomy?is?a?safe?alter-native? for? extended? hepatic? resection? in? selected? patients? at-tempting?to?preserve?the?functional?liver?parenchyma.
