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Hepatectomy with Hepatic vein resection and reconstruction

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https://www.readbyqxmd.com/read/28875398/total-hilar-en-bloc-resection-with-left-hemihepatectomy-and-caudate-lobectomy-a-novel-approach-for-treatment-of-left-sided-perihilar-cholangiocarcinoma-with-video
#1
Cai De Lu, Jing Huang, Sheng Dong Wu, Yong Fei Hua, Ammar A Javed, Jiong Zhe Fang, Chun Nian Wang, Sheng Ye
BACKGROUND: "Hilar en bloc resection" using a no-touch technique has been advocated as a standard procedure in right-sided hepatectomies for treatment of perihilar cholangiocarcinoma (PHC). In principle, it has never been reported for left-sided tumors. The aim is to describe the procedures of total hilar en bloc resection with left hemihepatectomy and caudate lobectomy (THER-LH) for advanced PHC and discuss feasibility and clinical significance of this novel technique. METHODS: A retrospective study using a prospectively maintained database was performed to identify eight patients who had received THER-LH for advanced PHC from January 2013 to December 2015...
September 5, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28675368/ante-situm-liver-resection-for-giant-hepatic-tumour-case-report-and-review-of-literature
#2
Vladislav Braşoveanu, Mihail Pautov, Mihnea Ioan Ionescu, Claudiu Anghel, Dan Ionut Dudus, Manish Moothoor, Florin Ichim, Eliza Gangone, Ion Barbu
Ex-situ liver surgery refers to complex liver resections involving hepatic vascular exclusion and a warm ischemia time (WIT) of more than 90 minutes that allows liver resection and vascular reconstruction in patients with giant liver tumours with a difficult approach . Ante-situm liver resections, otherwise called "œex-situ in-vivo" resections is achieved through externalization of the liver outside of the abdominal cavity by clamping and sectioning of the efferent pedicles (suprahepatic veins) ("ex situ") without cutting the afferent vascular pedicle ("in vivo"), thus leaving the hepatic pedicle intact...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28660678/safety-and-efficacy-of-the-venous-reconstruction-in-liver-resection-using-cryopreserved-homologous-veins
#3
Masaki Yamamoto, Nobuhisa Akamatsu, Akimasa Hayashi, Junichi Togashi, Yoshihiro Sakamoto, Sumihito Tamura, Kiyoshi Hasegawa, Masashi Fukayama, Masatoshi Makuuchi, Norihiro Kokudo
BACKGROUND: Only a few studies have reported the resection and reconstruction of major hepatic veins during hepatectomy. Here, we present our strategy and techniques for venous reconstruction with cryopreserved homologous veins, and describe the surgical outcome. METHODS: Among 2,387 hepatectomy patients, 39 patients who required hepatic venous reconstruction were reviewed retrospectively. Venous reconstruction was performed to secure a non-congested liver remnant volume of at least 40% of the total liver volume...
June 29, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28626378/partial-hepatectomy-with-middle-hepatic-vein-reconstruction-using-a-left-inferior-vena-cava-graft
#4
Yusuke Kawamoto, Yusuke Ome, Kazuyuki Kawamoto
Duplicated inferior vena cava (IVC) is a rare congenital anomaly. We describe the utility of a new graft from the left IVC in a patient with duplicated IVC for reconstructing the middle hepatic vein (MHV) after partial hepatectomy with MHV resection. A 67-year-old woman with hepatitis C was found to have a liver tumor. Magnetic resonance imaging confirmed that the tumor, which was attached to the MHV, was hepatocellular carcinoma. Central bisectionectomy (S4, S5, and S8 resection) could not be tolerated because of poor liver function and a low future liver remnant volume...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28549521/techniques-of-parenchyma-sparing-hepatectomy-for-the-treatment-of-tumors-involving-the-hepatocaval-confluence-a%C3%A2-reliable-way-to-assure-an-adequate-future-liver-remnant-volume
#5
Lucio Urbani, Piero Colombatto, Riccardo Balestri, Gabriella Licitra, Chiara Leoni, Francesco Forfori, Gianluca Masi, Piero Boraschi, Maura Castagna, Piero Buccianti
BACKGROUND: Parenchyma-sparing hepatectomy techniques allow a lesser volume resection (<3 adjacent segments) for tumors involving the hepatic veins at the hepatocaval confluence, assuring adequate volume of the future liver remnant. We report the ability to perform parenchyma-sparing hepatectomy as planned from the preoperative imaging and the type of vascular intervention used to preserve hepatic outflow. METHODS: We analyzed 60 consecutive parenchyma-sparing hepatectomies in 54 patients for 7 primary and 53 metastatic tumors (48 colorectal), located in segments I, VII, VIII, or IVa and involving the hepatocaval confluence...
September 2017: Surgery
https://www.readbyqxmd.com/read/28529988/left-hepatectomy-with-simultaneous-hepatic-artery-and-portal-vein-reconstructions-in-the-operation-for-cholangiocarcinoma-the-surgical-techniques-comprised-of-step-by-step-established-procedures
#6
Hideaki Uchiyama, Ken Shirabe, Kenichiro Araki, Keishi Sugimachi, Kazutoyo Morita, Kenji Takenaka, Yoshihiko Maehara
Hepatectomy needing simultaneous reconstruction of the hepatic artery and the portal vein in the operation for cholangiocarcinoma is a challenging procedure. We experienced three cases of left hepatectomy with simultaneous reconstructions of the right hepatic artery (RHA) and the right portal vein (RPV) in all of which the surgical procedures were performed in the same manner. At the initial step of the procedure, we confirmed that the RHA and the RPV at the porta hepatis as well as the proper hepatic artery and the main portal vein (MPV) proximal to the cancer involvement could be controlled by tapes, which meant the cancer could be resected by means of vascular reconstructions...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28288065/how-has-virtual-hepatectomy-changed-the-practice-of-liver-surgery-experience-of-1194-virtual-hepatectomy-before-liver-resection-and-living-donor-liver-transplantation
#7
Yoshihiro Mise, Kiyoshi Hasegawa, Shouichi Satou, Junichi Shindoh, Kenji Miki, Nobuhisa Akamatsu, Junichi Arita, Junichi Kaneko, Yoshihiro Sakamoto, Norihiro Kokudo
OBJECTIVE: To assess how virtual hepatectomy (VH), conducted using surgical planning software, influences the outcomes of liver surgery. BACKGROUND: Imaging technology visualizes the territories of the liver vessels, which were previously impossible. However, the clinical impact of VH has not been evaluated. METHODS: From 2004 to 2013, we performed 1194 VHs preoperatively. Outcomes of living donor liver transplantation (LDLT) and hepatectomy for hepatocellular carcinoma (HCC)/colorectal liver metastases (CRLM) were compared between patients in whom VH was performed (VH) and those without VH evaluation (non-VH)...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28207553/laparoscopic-living-donor-right-hemihepatectomy-with-venous-outflow-reconstruction-using-cadaveric-common-iliac-artery-allograft-case-report-and-literature-review
#8
Jiaxin Li, Jiwei Huang, Hong Wu, Yong Zeng
RATIONALE: With the development of laparoscopic technique, the total laparoscopic living donor right hemihepatectomy (LLDRH) procurement surgery has been successfully performed in many liver transplant centers all over the world, and the number of cases is continuing to increase. We report our case of laparoscopic right graft resection with venous outflow reconstruction using cadaveric common iliac artery allograft in our center and review literatures about total LLDRH surgery. PATIENT CONCERNS AND DIAGNOSES: A 40-year-old male living donor for right hepatectomy was selected after pretransplant evaluation including laboratory tests, liver volume, anatomy of hepatic vein, artery, portal vein, and bile duct...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28133129/-huge-hepatocellular-carcinoma-with-portal-vein-and-inferior-vena-cava-thrombi-treated-with-curative-liver-resection-and-perioperative-hepatic-arterial-infusion-chemotherapy-a-case-report
#9
Shinsaku Obara, Takeo Nomi, Ichirou Yamato, Daisuke Hokuto, Satoshi Yasuda, Chihiro Kawaguchi, Takahiro Yoshikawa, Masayuki Sho, Takatsugu Yamada, Takahiro Akahori, Shoichi Kinoshita, Minako Nagai, Hiromichi Kanehiro, Yoshiyuki Nakajima
The prognosis of hepatocellular carcinoma(HCC)with main portal vein(MPV)and/or the inferior vena cava(IVC)tumor thrombi is dismal. The management of HCC with severe tumor thrombus is complicated. In this study, we report a case of HCC with tumor thrombi in the MPV and IVC that was successfullytreated via liver resection and perioperative hepatic arterial infusion chemotherapy(HAI). A 68-year-old man was referred to our institution to treat huge HCC lesion in the right lobe of the liver. Abdominal computed tomography(CT)revealed a tumor(12 cm in diameter)in the right hepatic lobe and tumor thrombi in the MPV and IVC...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/27919848/surgical-outcomes-of-hepatocellular-carcinoma-invading-hepatocaval-confluence
#10
Wei Li, Hong Wu, Jun Han
BACKGROUND: Combined liver and inferior vena cava (IVC) resection followed by IVC and/or hepatic vein reconstruction (HVR) is a curative operation for selected patients with hepatocellular carcinoma (HCC) invading the hepatocaval confluence. The present study aimed to elucidate the prognostic factors for patients with HCC invading the hepatocaval confluence. METHODS: Forty-two consecutive patients underwent hepatectomy, combined with IVC replacement and/or HVR for HCC between January 2009 and December 2014 were included in this study...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27896655/transhepatic-hilar-approach-for-perihilar-cholangiocarcinoma-significance-of-early-judgment-of-resectability-and-safe-vascular-reconstruction
#11
Naohisa Kuriyama, Shuji Isaji, Akihiro Tanemura, Yusuke Iizawa, Hiroyuki Kato, Yasuhiro Murata, Yoshinori Azumi, Masashi Kishiwada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai
In the most common surgical procedure for perihilar cholangiocarcinoma, the margin status of the proximal bile duct is determined at the final step. Our procedure, the transhepatic hilar approach, confirms a cancer-negative margin status of the proximal bile duct first. We first performed a partial hepatic parenchymal transection to expose the hilar plate, and then transected the proximal bile duct to confirm margin status. Then, divisions of the hepatic artery and portal vein of the future resected liver are performed, followed by the residual hepatic parenchymal transection...
March 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27852277/right-hepatectomy-for-a-detoured-left-hepatic-artery-in-hilar-cholangiocarcinoma-report-of-a-rare-but-rational-resection
#12
Chun-Yi Tsai, Nobuyuki Watanabe, Tomoki Ebata, Takashi Mizuno, Yuzuru Kamei, Masato Nagino
BACKGROUND: Curative hepatectomy with bile duct resection is the treatment for perihilar cholangiocarcinoma. A locally advanced tumor necessitates hepatectomy with simultaneous vascular resection, and reconstruction remains an obstacle for surgeons. Studies have focused on the variations of hepatic arteries. Nevertheless, the anatomical alignment of the portal veins, bile ducts, and hepatic arteries are equally critical in surgical planning of curative resection for advanced tumors. We have reported promising outcomes of hepatectomy with simultaneous resection and reconstruction of the hepatic artery...
November 16, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27401445/parenchyma-sparing-hepatectomy-with-vascular-reconstruction-techniques-for-resection-of-colorectal-liver-metastases-with-major-vascular-invasion
#13
Saiho Ko, Yuuki Kirihataya, Masanori Matsusaka, Tomohide Mukogawa, Hirofumi Ishikawa, Akihiko Watanabe
BACKGROUND: Resectability of colorectal liver metastasis (CRLM) depends on major vascular involvement and is affected by chemotherapy-induced liver injury. Parenchyma-sparing with combined resection and reconstruction of involved vessels may expand the indications and safety of hepatectomy. METHODS: Of 92 patients who underwent hepatectomy for CRLM, 15 underwent major vascular resection and reconstruction. The reconstructed vessels were the portal vein (PV) in five cases, the major hepatic vein (HV) in nine cases, and the inferior vena cava in six cases...
August 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27384750/aggressive-hemihepatectomy-combined-with-resection-and-reconstruction-of-middle-hepatic-vein-for-intrahepatic-cholangiocarcinoma
#14
Akinori Miyata, Yoshihiro Sakamoto, Satoshi Yamamoto, Nobuhisa Akamatsu, Junichi Arita, Junichi Kaneko, Kiyoshi Hasegawa, Norihiro Kokudo
BACKGROUND: Major hepatectomy for intrahepatic cholangiocarcinoma (ICC) sometimes involves resection of major hepatic veins, which might result in the future liver remnant (FLR) congestion. The necessity and efficacy of resection and reconstruction of the middle hepatic vein (MHV) during right or left hemihepatectomy for resection of ICC remains unclear. METHODS: Between 1995 and 2013, 68 patients underwent right (n = 24) or left hemihepatectomy (n = 44) for primary ICC, with (n = 27) or without (n = 41) resection of MHV...
July 6, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27083897/usefulness-of-a-recanalized-umbilical-vein-for-vascular-reconstruction-in-pediatric-hepatic-surgery
#15
Masato Shinkai, Kyoko Mochizuki, Norihiko Kitagawa, Hiroshi Take, Hidehito Usui, Kaori Nakamura Yamoto, Shogo Fujita, Youkatsu Ohhama
PURPOSE: Pediatric surgeons currently engage in various abdominal vascular surgeries, which sometimes require vascular conduits or grafts. Herein, we report our experience with patients undergoing vascular reconstruction using a recanalized umbilical vein (rUV) and their long-term outcome. METHOD: Five patients with extrahepatic portal vein obstruction (EHPVO) underwent mesenterico-/porto-left portal vein (PV) bypass surgery using a short rUV conduit with an interposition vein graft...
June 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27076622/a-novel-technique-for-hepatic-vein-reconstruction-during-hepatectomy
#16
Rodrigo C Surjan, Tiago Basseres, Denis Pajecki, Daniel B Puzzo, Fabio F Makdissi, Marcel A C Machado, Alexandre Gustavo Bellorio Battilana
Surgical resection is the treatment of choice for malignant liver tumours. Nevertheless, surgical approach to tumours located close to the confluence of the hepatic veins is a challenging issue. Trisectionectomies are considered the first curative option for treatment of these tumours. However, those procedures are associated with high morbidity and mortality rates primarily due to post-operative liver failure. Thus, maximal preservation of functional liver parenchyma should always be attempted. We describe the isolated resection of Segment 8 for the treatment of a tumour involving the right hepatic vein and in contact with the middle hepatic vein and retrohepatic vena cava with immediate reconstruction of the right hepatic vein with a vascular graft...
April 13, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27070877/-reconstruction-of-hepatic-veins-in-liver-resection-technique-and-possibility-of-prophylaxis-of-posthepatectomy-liver-failure
#17
R B Alikhanov, V A Kubishkin, A V Dubrovskiy, M G Efanov
BACKGROUND: Invasion of hepatic veins by liver tumor limits parenchyma-preserving liver resection. We analyzed different technique of hepatic vein reconstruction and possibility of prophylaxis of post hepatectomyliver failure in patients with compromised liver function. METHODS AND CLINICAL DATA: From 2010 to 2015 performed 199 liver resections. Reconstruction of hepatic veins performed in 9 (4.5%). Among them 3 patients was with hepatocellular carcinoma and 6 patients with colorectal liver metastases...
2016: Khirurgiia
https://www.readbyqxmd.com/read/26805161/-synchronous-triple-malignant-tumors-hilar-cholangiocarcinoma-ascending-colon-cancer-liposarcoma-resected-in-a-two-stage-procedure-a-case-report
#18
Sho Yasuta, Junichiro Yamauchi, Ataru Satoh, Tomoya Ikeda, Shota Fujita, Yasufumi Matsuda, Shin Kobayashi, Takashi Ajiki, Katsuo Tsuchihara, Noriko Kondo, Shuichi Ishiyama
A 70-year-old man with a history of myocardial infarction (MI) and taking 2 antiplatelet drugs was diagnosed with anemia his 6-month post-MI checkup. A lower gastrointestinal endoscopy detected ascending colon cancer, and contrast-enhanced a computed tomography scan revealed hilar cholangiocarcinoma as well as lesions suspicious for gastrointestinal stromal tumors of the small intestine. The patient was given a preoperative diagnosis of synchronous triple malignant tumors. The decision to perform a two-stage procedure was made for the following reasons: the impossibility of discontinuing antiplatelet drugs 6 months after drug-eluting stent placement, continuous bleeding due to colon cancer and the possibility of suffering severe stress from surgery while at high risk for diseases such as hepatic failure...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/26356493/inferior-vena-cava-reconstruction-for-leiomyosarcoma-of-zone-i-iii-requiring-complete-hepatectomy-and-bilateral-nephrectomy-with-autotransplantation
#19
Hoylan T Fernandez, Peter T W Kim, Tiffany L Anthony, Baron L Hamman, Robert M Goldstein, Giuliano Testa
The inferior vena cava (IVC) is the most common site of leiomyosarcomas arising from a vascular origin. Leiomyosarcomas of the IVC are categorized by anatomical location. Zone I refers to the infrarenal portion of the IVC, Zone II from the hepatic veins to the renal veins, and Zone III from the right atrium to the hepatic veins. This is a rare presentation of a Zone I-III leiomyosarcoma. Fifty-two-years-old female with a medical history significant only for HTN was admitted to the hospital with bilateral lower extremity edema and dyspnea...
October 2015: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/26200628/minor-but-complex-liver-resection-an-alternative-to-major-resections-for-colorectal-liver-metastases-involving-the-hepato-caval-confluence
#20
Lucio Urbani, Gianluca Masi, Marco Puccini, Piero Colombatto, Caterina Vivaldi, Riccardo Balestri, Antonio Marioni, Valerio Prosperi, Francesco Forfori, Gabriella Licitra, Chiara Leoni, Adriana Paolicchi, Piero Boraschi, Alessandro Lunardi, Carlo Tascini, Maura Castagna, Piero Buccianti
Major hepatectomy (MH) is often considered the only possible approach for colorectal liver metastasis (CRLM) at the hepato-caval confluence (CC), but it is associated with high morbidity and mortality. With the aim to reduce MH, we developed the "minor-but-complex" (MbC) technique, which consists in the resection of less than 3 adjacent liver segments with exposure of the CC and preservation of hepatic outflow until spontaneous maturation of peripheral intrahepatic shunts between main hepatic veins. We have evaluated applicability and outcome of MbC resections for the treatment of CRLM involving the CC...
July 2015: Medicine (Baltimore)
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