A Glissonean Approach with Individual Isolation During Right Hemi-Hepatectomy After Portal Vein Embolization

Background/Aim: Although the Glissonean approach in hemi-hepatectomy is a very useful technique, right hemi-hepatectomy with Glissonean approach after portal vein embolization (PVE) is difficult because of the obstructing materials located at the right portal branch. The aim of this study was to evaluate the utility of the Glissonean approach with an individual isolation technique (GI technique) in right hemi-hepatectomies after PVE. Patients and Methods: We retrospectively analyzed 21 patients who underwent the GI technique between March 2007 and June 2012. Results: In one of the 21 patients, we could not perform the GI technique because of severe adhesions following previous operation; however, there were no troubles in the remaining 20 cases. In addition, none of the patients that were treated using this method developed massive ascites after right hemi-hepatectomy, despite 8 patients (40%) exhibiting severe fibrosis (F3 or F4). Conclusion: Even in right hemi-hepatectomy following PVE, our GI technique may be a useful procedures for patients.

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