Background : Limited anatomical liver resection could provide the oncological quality to achieve radical surgery and the safety of the parenchyma sparing principle. However, anatomical segmentectomy ins technically difficult due to the complexity of the segmental liver anatomy.

Methods : This report described two different bisegmentectomies as an safe alternative to right hepatectomy without postoperative morbidity and long-term tumor recurrence.

Results : In case 1, A 57-year-old woman with known hepatitis B related liver cirrhosis was referred for management to hepatocellular carcinoma and dynamic CT scan demonstrated large HCC infiltrating right hepatic vein (RHV) at segment 7 and 8 and two inferior RHV. She underwent bisegmenectomy instead of right hepatectomy. In case 2, A 57-year-old woman was referred with hepatic mass. Liver MRI demonstrated 4cm sized liver tumor located in segment 5 and 6. Needle biopsy for the tumor revealed adenocarcinoma which was compatible with intrahepatic cholangiocarcinoma. She received laparoscopic S5,6 bisegmentectomy instead of right hepatectomy due to small left remnant liver.

Conclusions : Bi-segmentectomy 5&6 / 7&8 could be a safe anatomical liver resection as alternative to right hepatectomy and allows curative resection without unnecessary sacrifice of functional parenchyma with minimal morbidity.