An82-year-oldmanwasadmittedtoourhospitalduetogrosshematochezia.Colonoscopyshoweda circumferentialtype3tumorinthesigmoidcolon.Computedtomography(CT)showedmultiplehepatocellularcarcinomas(HCCs)withmaximumdiametersof10cminS4/5/8and5cminS7,forwhichright hepatic trisegmentectomy was indicated because the predicted future liver remnant (FLR) was 43%. Laparoscopic portal vein ligation (PVL) was performed following laparoscopic sigmoidectomy. Four weekspostoperatively,theFLRreached63%withICG-K0.072,andthepatientunderwentrighthepatic trisegmentectomy.Thepatienthadanuneventfulpostoperativecourseandunderwentadjuvantchemotherapyforcoloniccancer.Laparoscopicportalligationisfeasibleinsomepatientswithlivercancerconcomitantwithothergastroinstestinaldisease.Thismethodmaybeasuperiorchoiceforselectedpatients withHCCbecauseitdecreasespotentialmorbidityassociatedwithpercutaneoustranshepaticportalvein embolization.
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