AIM:To report the devised anatomic liver resection of segments 6,7 and 8 to improve the resection rate for patients with right liver tumors.METHODS:We performed anatomic liver resection of segments 6,7 and 8 to guarantee the maximum preservation of the remaining normal liver tissue.Segment 5 was determined by two steps of Glissonean pedicle occlusion.And a"┏┛"shaped broken resection line was marked upon the diaphragmatic surface of the liver.Selective right hemihepatic inflow occlusion was used to reduce blood loss during parenchymal transection between segments 6 and 5 and between segments 8 and 5.If needed,total hepatic Glissonean pedicle occlusion was used during parenchymal transection between segment 8 and the left liver.RESULTS:Compared to right hemihepatectomy,the percentage of future liver remnant volume was increased by an average of 13.9%if resection of segments 6,7 and 8 was performed.Resection of segments 6,7 and 8 was completed uneventfully.After hepatectomy,the inflow and outflow of segment 5were maintained.There was no perioperative mortality,postoperative abdominal bleeding or bile leakage in this group.Alpha-fetoprotein(AFP)returned to the normal range within 2 mo after the operation in all the patients.One patient died 383 d postoperatively due to obstructive suppurative cholangitis.One patient suffered from severe liver dysfunction shortly after surgery and had intrahepatic recurrence 4 mo postoperatively.Postoperative lung metastasis was found in one patient.No tumor recurrence was found in the other patients and the parameters including liver function and AFP level were in the normal range.CONCLUSION:Anatomic liver resection of segments6,7 and 8 can be a conventional operation to improve the overall resection rate for hepatocellular carcinoma.
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