EXTENDED CENTRAL BISEGMENTECTOMY - AN EN-BLOC RESECTION OF HEPATIC SEGMENT-4, SEGMENT-5, SEGMENT-8 AND SEGMENT-7 - REPORT OF A CASE

We herein present an example of an extended central bisegmentectomy in a patient with a large hepatocellular carcinoma. According to a magne tic resonance imaging study, the right hepatic vein was displaced and narrowed at its origin and a large inferior right hepatic vein was rev ealed. In this case, owing to the only slightly functional remaining h epatic reserve, an extended central bisegmentectomy was selected as th e optimum treatment. The postoperative course was uneventful except fo r some bile leakage. Twelve months after operation, the patient is sti ll alive and no sign of recurrence has been detected. The extended cen tral bisegmentectomy is an en bloc resection of hepatic segments 4, 5, 7, and 8. When the large inferior right hepatic vein is present, segm ent 6 can be preserved even when the right hepatic vein is sacrificed at its origin.