Two-step hepatectomy with right portal branch ligature for a right lobe metastasis.

AIMS/BACKGROUND: Hepatic resection is the only treatment with possible curative effect both for primary and secondary tumors. An increase of the rate of resectability for tumors considered inoperable at first and a decrease of the postoperative morbidity and mortality can be realized by right portal branch ligature and two-step hepatectomy.

METHODOLOGY

This paper presents the case of a patient with left bowel cancer with a hepatic metastasis. A right portal branch ligature was performed followed by systemic postoperative chemotherapy.

RESULTS

The right portal branch occlusion was followed by right lobe atrophy and left lobe hypertrophy, confirmed by CT scan. Three months after the portal occlusion a right lobe hepatectomy was performed. The postoperative evolution was favorable; eight days of hospitalization were necessary.

CONCLUSIONS

Portal branch ligature can be performed in certain cases of hepatic tumors to increase the resectability rate.