保留S₆并V₆肝内血管重建的扩大中肝切除1例
Extended Mesohepatectomy with S₆ and V₆ Intrahepatic Vascular Reconstruction: Case Report

中肝切除是肝脏手术中间较困难的一种方式，通常中肝切除指S₄、S₅₊₈或S₄₊₅₊₈段的切除，鲜有合并S₇段的中肝切除。在合并S₇段的扩大中肝切除时，需要保留S₆段有独立且完整的回流静脉。本文报道1例肝肿瘤侵犯S₄₊₅₊₈段、S₇段、RHV、中肝静脉(middle hepatic vein, MHV)，且S₆段回心血流在根部有癌栓浸润患者，行保留肝脏S₂、S₃、S₆段，联合下腔静脉癌栓取出并部分IVC切除，同时将保留的S₆肝静脉与IVC再次吻合的手术经过。
Mesohepatectomy is a difficult method in liver surgery. Generally, mesohepatectomy refers to the resection of S₄, S₅₊₈ or S₄₊₅₊₈ segments, but rarely combines with S₇ segment hepatectomy. In the mesohepatectomy combined with S₇ segment, it is necessary to keep an independent and complete draining vein for S₆ segment. This article reports a case of hepatocarcinoma invading S4+5+8 segment, S₇ segment, RHV, middle hepatic vein (MHV), and one of draining vein for S₆ segment which flows into inferior RHV is filled with tumor thrombus. In this patient we performed extended mesohepatectomy, removed the IVC tumor thrombus and partial IVC, and re-anastomosed the remaining S₆ hepatic vein to IVC.