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New two-step wedge liver resection technique: “zoom resection”: A case report
Ann Hepatobiliary Pancreat Surg 2018 Nov;22(4):412-5
Published online November 30, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Guillermo Pfaffen, Nicolas Ortiz, José Sotelo, Rodrigo Moran Azzi, Victor Serafini

Hepatobiliary and Pancreatic Surgical Unit, Sanatorio Güemes–University Hospital, Cuidad Autónoma de Buenos Aires, Argentine
Received June 13, 2018; Revised June 29, 2018; Accepted June 29, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Different surgical procedures have been described for the treatment of colorectal liver metastases. The appropriate surgical approach depends, among many other factors, on the relationship between liver metastases and suprahepatic veins. If possible, the detachment of colorectal liver metastasis from suprahepatic veins is a good alternative liver parenchyma sparing technique. In this study, we describe a new two-step wedge liver resection technique for colorectal liver metastases located between suprahepatic veins. Prior to resection, intraoperative ultrasound is employed in order to plan and guide both steps. Initially, we place stitches and resect a cylindrical piece of normal liver parenchyma above the tumor and suprahepatic veins. Next, we place stitches on the future specimen located between suprahepatic veins, then resect it. The main advantages of this procedure are the good visualization and vascular control that may be achieved during the detachment of the tumor from suprahepatic veins. We call this procedure “zoom resection” because its dynamics are similar to the workings of a photograph camera's telescopic system. We present the case of a 55-year-old patient diagnosed with multiple colorectal liver metastases, one of which was resected through this technique.
Keywords : Metastasis; Liver; Wedge resection

 

November 2018, 22 (4)