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Hepatectomy with Hepatic vein resection and reconstruction

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...
July 11, 2016: Annals of Surgical Oncology
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
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
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...
2016: Journal of Surgical Case Reports
R B Alikhanov, V A Kubyshkin, A V Dubrovsky, 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
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
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
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)
Helayel Almodhaiberi, Shin Hwang, Yoo-Jeong Cho, Yongjae Kwon, Bo-Hyun Jung, Myeong-Hwan Kim
Left-sided gallbladder (LSGB) is a rare anomaly, but it is often associated with multiple combined variations of the liver anatomy. We present the case of a patient with LSGB who underwent successful resection of perihilar cholangiocarcinoma. The patient was a 67-year-old male who presented with upper abdominal pain and obstructive jaundice. Initial imaging studies led to the diagnosis of Bismuth-Corlette type IIIB perihilar cholangiocarcinoma. Due to the unique location of the gallbladder and combined multiple hepatic anomalies, LSGB was highly suspected...
February 2015: Korean Journal of Hepato-biliary-pancreatic Surgery
Safi Dokmak
BACKGROUND: Venous resections are frequent during hepatopancreatobiliary (HPB) surgery and a rapidly available graft may be needed, especially if it had not been planned preoperatively.1 (-) 3 Our group recently reported results on the use of the parietal peritoneum (PP) as an autologous substitute graft (ASG) for reconstruction of the mesentericoportal vein (MPV) in 30 patients for the first time.4 METHODS: Between December 2010 and January 2015, a total of 52 patients underwent HPB surgery with venous resection/reconstruction with the PP...
December 2015: Annals of Surgical Oncology
Fu-Qiang Wang, Qian Lu, Jun Yan, You-Yuan Peng, Cheng-Rong Xie, Yong-Jie Su, Jian-Yin Zhou, Bo-Liang Wang, Wen-Xiu Zhao, Xiao-Min Wang, Ping Bie, Zhen-Yu Yin
We previously reported the case of a 56-year-old male who underwent surgical treatment for gastric hepatoid adenocarcinoma and splenic metastasis. The present study reports the case of the same patient who underwent successful ex vivo hepatectomy and partial liver autotransplantation. Computed tomography scans demonstrated that the tumor was located in the left and caudate lobes of the liver, with hepatic vein and inferior vena cava involvement, and right portal vein compression. To clarify the association between the vessels and the tumor, a three-dimensional imaging technique was used to reconstruct the liver architecture...
May 2015: Oncology Letters
Nan Xiang, Chihua Fang
OBJECTIVE: To study the value of hepatic segment resection combined with rigid choledochoscope by the three-dimensional (3D) visualization technology in the diagnosis and treatment of complex hepatolithiasis. METHODS: Enhance computed tomography (CT) data of 46 patients with complex hepatolithiasis who were admitted to the Zhujiang Hospital of the Southern Medical University from July 2010 to June 2014 were collected.All of the CT data were imported into the medical image three-dimensional visualization system (MI-3DVS) for 3D reconstruction and individual 3D types...
May 2015: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Chihua Fang, Zhaoshan Fang, Yingfang Fan, Jianyi Li, Fei Xiang, Haisu Tao
OBJECTIVE: To study the value of three-dimensional (3D) visualization, 3D printing and 3D laparoscopy (3-3D techniques) in the diagnosis and surgical treatment of hepatic tumors. METHODS: From November 2013 to January 2015, 22 patients with hepatic tumors admitted in our department underwent abdominal thin-slice CT scanning. The CT images were imported into Medical Image three Dimensional Visualization System (MI-3DVS) for 3D reconstruction. Standard Template Library (STL) files were exported for 3D printing...
May 2015: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Mohamed T Ashour, Magdy Elsebae, Hussein Ezzat, Mohammed S Hedaya, Mohamed N H Taweela, Abdu Elbanna
Portal vein arterialization (PVA) is often referred to as a salvage procedure for insufficient arterial or portal inflow. Its main role focuses on two domains, liver transplantation and extensive surgery for malignancies of liver, biliary tract and pancreas. It ha been applied in treatment of fulminant hepatic failure due to intoxications and as a bridging procedure for transplantation or re-transplant. Radical resections with arterial reconstruction are a major challenge for surgeons especially in prolonging survival in advanced malignancies of the liver or biliary tract...
April 2015: Journal of the Egyptian Society of Parasitology
Abuzer Dirican, Mustafa Özsoy, Bora Barut, Volkan İnce, Mustafa Ateş, Sezai Yılmaz
Hepatic resection is the only known curative treatment option in primary and metastatic liver tumors. Unlike other types of malignancies, the response rate to even the best chemotherapy protocols is quite low in liver malignancies. Survival is expressed in months in untreated liver malignancies or in patients with residual tumor after resection. The optimal survival can be achieved only by liver resection with negative surgical margins. In order to increase the number of patients suitable for hepatic resection, techniques such as portal vein embolization, neoadjuvant chemotherapy, two-step hepatectomy, re-do hepatectomy, hypothermic liver perfusion have been developed and newer modalities are still being investigated...
2014: Ulusal Cerrahi Dergisi
Fei Tian, Jian-Xiong Wu, Wei-Qi Rong, Li-Ming Wang, Fan Wu, Wei-Bo Yu, Song-Lin An, Fa-Qiang Liu, Li Feng, Chao Bi, Yun-He Liu
AIM: To describe a three-dimensional model (3DM) to accurately reconstruct anatomic relationships of centrally located hepatocellular carcinomas (HCCs). METHODS: From March 2013 to July 2014, reconstructions and visual simulations of centrally located HCCs were performed in 39 patients using a 3D subject-based computed tomography (CT) model with custom-developed software. CT images were used for the 3D reconstruction of Couinaud's pedicles and hepatic veins, and the calculation of corresponding tumor territories and hepatic segments was performed using Yorktal DMIT software...
April 21, 2015: World Journal of Gastroenterology: WJG
S Sudhindran, Ramachandran N Menon, Dinesh Balakrishnan
Adult-to-adult living donor liver transplant (LDLT) frequently depend on using the right-lobes of the donor for obtaining adequate graft-to-recipient weight ratio (GRWR) of over 0.8% in the recipient. However, left-lobes remain an important option in adults, since the morbidity in the donor is considerably less with left donor hepatectomy when compared with right side liver resection. Further benefits of left-lobes in LDLT include more predictable anatomy of the left hepatic duct and left portal vein, which are usually long and single resulting in easier anastomosis in the recipient...
June 2012: Journal of Clinical and Experimental Hepatology
Yusuke Matsuura, Hiroshi Wada, Yoshito Tomimaru, Akira Tomokuni, Naoki Hama, Koichi Kawamoto, Shogo Kobayashi, Shigeru Marubashi, Hidetoshi Eguchi, Koji Umeshita, Yuichiro Doki, Masaki Mori, Hiroaki Nagano
We report a case of curatively resected intrahepatic cholangiocarcinoma (ICC) with hepatic artery (HA) and portal vein (PV) reconstruction. A 25-year-old man was diagnosed with ICC. Computed tomography (CT) showed that the tumor had invaded the left and common hepatic duct, the right and left HA, and the main branch of the PV. Because the posterior HA was tumor free, we performed a left trisegmentectomy, PV and HA resection and reconstruction, and a hepatocholangiojejunostomy. Pathological examination revealed a tumor classification of T3, N1, M0, Stage IVB...
November 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kazuhiko Hashimoto, Takeshi Tono, Kentaro Nishida, Ryouji Nonaka, Ryou Tsunashima, Yujiro Fujie, Shoichiro Fujita, Junya Fujita, Tetsuya Yoshida, Tadashi Ohnishi, Shingi Imaoka, Takushi Monden
A 67-year-old-man came to our hospital for further evaluation of a liver tumor detected by abdominal ultrasonography at another hospital. Abdominal computed tomography showed a tumor (8 cm in diameter)in the left lobe of the liver, with invasion of the left and middle hepatic veins, and multiple lymph node metastases. Liver biopsy examination revealed intrahepatic cholangiocellular carcinoma (cStage IVB). Therefore, chemotherapy with gemcitabine(GEM)was administered. The hepatic tumor and multiple lymph nodes were reduced in size after eight courses of GEM chemotherapy...
November 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hisateru Komatsu, Akira Tomokuni, Hiroshi Wada, Shogo Kobayashi, Yoshito Tomimaru, Tadafumi Asaoka, Naoki Hama, Koichi Kawamoto, Shigeru Marubashi, Hidetoshi Eguchi, Koji Umeshita, Yuichiro Doki, Masaki Mori, Hiroaki Nagano
A 61-year-old man presented with lower abdominal pain. Further examination revealed descending colon cancer and multiple liver metastases (S1, S2, and S5). The largest metastatic lesion in S1 showed massive invasion to the inferior vena cava (IVC) and was considered unresectable. Resection of the primary colon cancer was performed in January 2011, followed by several types of systemic chemotherapy(12 courses of capecitabine plus oxaliplatin [XELOX] + bevacizumab[Response Evaluation Criteria In Solid Tumors{RECIST}: PD], 5 courses of folinic acid, fluorouracil, and irinotecan [FOLFIRI] + bevacizumab[RECIST: SD], and 13 courses of FOLFIRI+ panitumumab)...
November 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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