Better surgical treatment method for hepatocellular carcinoma with portal vein tumor thrombus

Figure 1 The “thrombectomy first” approach. A: The right hepatic artery (RHA) was isolated and dissected. B: The right hepatic duct (RHD) was isolated and dissected. C: The left portal vein (LPV), right portal vein (RPV) and the main portal vein (PV) were clearly revealed by dissecting the hepatic artery-hepatic duct (HA-HD) flap. D: The tumor thrombus in the RPV and main portal vein (MPV) was extracted. E: The tape of LPV and PV were both released to flush the remnant tumor thrombus. RHA: Right hepatic artery; RHD: Right hepatic duct; LPV: Left portal vein; RPV: Right portal vein; PV: Portal vein; MPV: Main portal vein; HA-HD: Hepatic artery-hepatic duct.