[Reconstruction of hepatic veins in liver resection. Technique and possibility of prophylaxis of posthepatectomy liver failure].

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. Resections of segment 7, 8 was performed in 2 patients, resection of segments 4, 5, 8 - in 3 patients, right hepatectomy in 2 patients, left hepatectomy in 1 patient, resection of segment 4A, 8 - in one patient. Reconstruction of right hepatic vein was performed in 6 patients (Gortex), middle hepatic vein in three patients (2 - gonadal vein, 1 - inferior mesenteric vein).

RESULTS: Blood lost was estimated from 150 1700 ml. All patients had R0 radical resection There was no mortality. One patient had severe hepatic failure. Thrombosis of reconstructed of hepatic vein happened in one patient on 9(th) day post operation.

CONCLUSION: Reconstruction of hepatic veins allow to safely perform radical parenchyma-preserving liver resection in patients with compromised liver function due to liver cirrhosis, fibrosis or steatosis.