A case of partial autotransplantation of the liver in advanced hepatocellular carcinoma

Hepatocellular carcinoma in Japan iis frequently complicated by chronic hep atic disease such as chronic hepatitis and liver cirrhosis, and it is often impossible to decide the range to be resected only based on clinical stage and other tumor factors. We experienced a case with advanced hepatocellula r carcinoma complicated by liver cirrhosis that directly infiltrated into t he right and middle hepatic vein. Right trisegmentectomy was performed, the tumor site was extracorporeally removed and the hepatic posterior segment was autotransplanted. An anastomosis of the right hepatic vein and the infe rior vena cava was performed with a vascular prosthesis. The patencies of t he anastomosed vessels in the vascular reconstructions were confirmed by Do ppler sonography, which was very useful, providing an easy and exact evalua tion of hepatic blood flow at the patient's bedside. Throughout the post-op erative course before the patient's discharge, no abnormal hepatic function was found. Though cases for which partial hepatic autotransplantation is a ppropriate may be few, this operation procedure, which applies hepatic tran splantation techniques, is significant in that it increases the resectabili ty and achieves curative resection of hepatocellular carcinoma.