Introduction : When tumor is involving segment 7 and 8 at the same time close to right hepatic vein (RHV) or invading/abutting RHV in segment 7 or 8, absence of significant right inferior hepatic vein usually mandates right hemihepatectomy.

Methods : In such cases, we prefer bisegmentectomy 7-8 with RHV reconstruction using technique of direct re-anastomosis between RHV stump on liver cut-surface and that on IVC-side by approximating both ends through folding of segment 5-6 towards caudal direction.

Results : This technique has several advantages over technique of RHV reconstruction using artificial graft or cryopreserved cadaveric iliac vein, which are 1) only one anastomosis is required, which is easier and quicker, 2) avoidance of using foreign material, 3) decreased risk of kinking or distortion of anastomosis when remnant liver was placed back in position.

Conclusions : This technique can preserve segment 5 and 6 without compromise in oncologic principle while maximizing remnant liver volume and function.