PMC7098364_01
Preoperative enhanced CT presents two of the 36 x 31 mm and 8 x 7 mm sized masses at segment VIII. a Plain scan phase. b Arterial phase. c Portal phase. d Delayed phase.
crg-0014-0091-g01.jpg
PMC7098364_01_crg-0014-0091-g01.jpg
F1
The upper-abdominal enhanced CT scan revealed two high-density areas (36 x 31 mm and 8 x 7 mm, respectively) in segment VIII (Fig. 1) and one high-density area (5 x 5 mm) in segment VI (Fig. 2) of the liver.
Intraoperative photography of the right hemihepatectomy of HCC patients with SIT. a, b Selective isolation and ligation of the right hepatic artery (a, red arrow) and right portal vein (b, blue arrow) using the intra-Glissonian approach. c Ischemic line of the right liver. d Liver cross-section before right hepatic vein disconnection.
crg-0014-0091-g03.jpg
PMC7098364_01_crg-0014-0091-g03.jpg
F3
Selective hemihepatic vascular inflow occlusion via the intra-Glissonian approach was used to control the hepatic blood flow (Fig. 3a, b). Then, along the actual ischemic line of the right liver (Fig. 3c), the hepatic parenchyma transection from the surface of the liver parenchyma to the superficial layer of the vena cava was performed using an ultrasound scalpel and by bipolar electrocoagulation (Fig. 3d).