Four new hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein.

Among the accessory hepatic veins, the thickest one is the IRHV and is a significant vessel in 20 to 24 per cent of the patients. In these patients, if the right hepatic vein is totally resected, the right posteroinferior area can be preserved with the IRHV. Four types of hepatectomies n which the IRHV was preserved were proposed and three of the four procedures were performed upon five patients. In these five operations, the hepatectomies were successfully performed and blood losses were from 1,020 to 3,200 milliliters. These operative procedures, which have not been described before, could widen the indication of hepatectomy in patients with reduced liver function and tumor involving the right hepatic vein. In order to perform these operative procedures successfully, intraoperative sonography is indispensable.