Extended Right Hepatectomy in a Liver with a Non-bifurcating Portal Vein: the Hanging Maneuver Protects the Portal System in the Presence of Anomalies

2013 ◽  
Vol 17 (8) ◽  
pp. 1494-1499 ◽  
Author(s):  
Ser Yee Lee ◽  
Daniel Cherqui ◽  
Michael D. Kluger
Keyword(s):  
Portal Vein ◽  
Portal System ◽  
Right Hepatectomy ◽  
Hanging Maneuver ◽  
Extended Right Hepatectomy

scholarly journals Oncological Outcomes after Liver Venous Deprivation for Colorectal Liver Metastases: A Single Center Experience

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 200
Author(s):  
Salah Khayat ◽  
Gianluca Cassese ◽  
François Quenet ◽  
Christophe Cassinotto ◽  
Eric Assenat ◽  
...  
Keyword(s):  
Portal Vein ◽  
Liver Metastases ◽  
Portal Vein Embolization ◽  
Colorectal Liver Metastases ◽  
Future Liver Remnant ◽  
Small Sample ◽  
Right Hepatectomy ◽  
Liver Remnant ◽  
Oncological Outcomes ◽  
Extended Right Hepatectomy

Colorectal liver metastases (CRLM) are the major cause of death in patients with colorectal cancer (CRC). The cornerstone treatment of CRLM is surgical resection. Post-operative morbidity and mortality are mainly linked to an inadequate future liver remnant (FLR). Nowadays preoperative portal vein embolization (PVE) is the most widely performed technique to increase the size of the future liver remnant (FLR) before major hepatectomies. One method recently proposed to increase the FLR is liver venous deprivation (LVD), but its oncological impact is still unknown. The aim of this study is to report first short- and long-term oncological outcomes after LVD in patients undergoing right (or extended right) hepatectomy for CRLM. Seventeen consecutive patients undergoing LVD between July 2015 and May 2020 before an (extended) right hepatectomy were retrospectively analyzed from an institutional database. Post-operative and follow-up data were analyzed and reported. Primary outcomes were 1-year and 3-year overall survival (OS) and hepatic recurrence (HR). Postoperative complications occurred in 8 patients (47%). No deaths occurred after surgery. HR occurred in 9 patients (52.9%). 1-year and 3-year OS were 87% (95% confidence interval [CI]: ±16%) and 60.3%, respectively (95% CI: ±23%). Median Disease-Free Survival (DFS) was 6 months (CI 95%: 4.7–7.2). With all the limitations of a retrospective study with a small sample size, LVD showed similar oncological outcomes compared to literature reports for Portal Vein Embolization (PVE).

scholarly journals Impact of portal vein embolisation on early outcomes from right and extended right hepatectomy

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e697-e698
Author(s):  
H. Nageswaran ◽  
A. Belgaumkar ◽  
A. Riga ◽  
T. Worthington ◽  
N. Karanjia
Keyword(s):  
Portal Vein ◽  
Right Hepatectomy ◽  
Portal Vein Embolisation ◽  
Extended Right Hepatectomy

scholarly journals Right extended hepatectomy for hilar cholangiocarcinoma: A case report

2020 ◽  
Vol 9 (3) ◽  
pp. 173-176
Author(s):  
Romi Dahal ◽  
Krishna Mohan Adhikari ◽  
Sumita Pradhan ◽  
Ramesh Singh Bhandari
Keyword(s):  
Portal Vein ◽  
Hilar Cholangiocarcinoma ◽  
Hepatic Duct ◽  
Future Liver Remnant ◽  
Operation Time ◽  
Common Hepatic Duct ◽  
Right Hepatectomy ◽  
Liver Remnant ◽  
Extended Right Hepatectomy ◽  
The Right

Radical resection in a case of hilar cholangiocarcinoma is the only curative option. However resection in a hilar cholangiocarcinoma is a challenging procedure because of the low resectability rate. Only a few cases of hilar cholangiocarcinoma are operable because of the advanced nature of disease at presentation. Furthermore, the extent of surgery makes it a complicated process to attempt. We recently had a patient who underwent an open extended right hepatectomy and hepaticojejunostomy for a type IIIa hilar cholangiocarcinoma. The tumor was 20 mm in diameter and was located between the right hepatic duct and common hepatic duct. Radiological examination showed that the hepatic artery was not involved but the right portal vein was invaded by the tumor. CT volumetry was done and the future liver remnant was only 20% in the jaundiced patient. Preoperative drainage was done with percutaneous transhepatic biliary drainage from the left side. Portal vein embolization was done to augment future liver remnant to 30%. The patient underwent an extended right hepatectomy (right trisectionectomy combined with caudate lobectomy). The operation time was nearly 300 min, and the intraoperative blood loss was about 500 ml. However, in the postoperative period, the patient developed post hepatic liver failure which was managed successfully with conservative treatment. The postoperative hospital stay was 23 days. The final diagnosis was hilar cholangiocarcinoma with no nodal metastasis (pT2bN0M0) stage II (American Joint Committee on Cancer, AJCC).

scholarly journals A Comparison of Portal Vein Embolization With Poly(2-hydroxyethylmethacrylate) and a Histoacryl/Lipiodol Mixture in Patients Scheduled for Extended Right Hepatectomy

2015 ◽  
pp. 841-848 ◽  
Author(s):  
J. H. PEREGRIN ◽  
R. JANOUŠEK ◽  
D. KAUTZNEROVÁ ◽  
M. OLIVERIUS ◽  
E. STICOVÁ ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Right Hepatectomy ◽  
Portal Vein Branch ◽  
Liver Remnant ◽  
Extended Right Hepatectomy ◽  
The Right ◽  
Transhepatic Access ◽  
Flr Hypertrophy

ght hepatectomy and whether it is as effective as the currently used agent (a histoacryl/lipiodol mixture). Two groups of nine patients each scheduled for extended right hepatectomy for primary or secondary hepatic tumor, had right portal vein embolization in an effort to induce future liver remnant (FLR) hypertrophy. One group had embolization with PHEMA, the other one with the histoacryl/lipiodol mixture. In all patients, embolization was performed using the right retrograde transhepatic access. Embolization was technically successful in all 18 patients, with no complication related to the embolization agent. Eight patients of either group developed FLR hypertrophy allowing extended right hepatectomy. Likewise, one patient in each group had recanalization of a portal vein branch. Histology showed that both embolization agents reach the periphery of portal vein branches, with PHEMA penetrating somewhat deeper into the periphery. PHEMA has been shown to be an agent suitable for embolization in the portal venous system comparable with existing embolization agent (histoacryl/lipiodol mixture).

Infusion of CD133+ Bone Marrow–Derived Stem Cells After Selective Portal Vein Embolization Enhances Functional Hepatic Reserves After Extended Right Hepatectomy

2012 ◽  
Vol 255 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Jan Schulte am Esch ◽  
Moritz Schmelzle ◽  
Günther Fürst ◽  
Simon C. Robson ◽  
Andreas Krieg ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Portal Vein ◽  
Portal Vein Embolization ◽  
Right Hepatectomy ◽  
Extended Right Hepatectomy

Totally Minimally Invasive Extended Right Hepatectomy Using the Intracorporal Liver Hanging Maneuver

Videoscopy ◽  
2019 ◽  
Vol 29 (4) ◽  
Author(s):  
Robert Sucher ◽  
Hans Michael Hau ◽  
Sebastian Rademacher ◽  
Andri Lederer ◽  
Tim Ole Petersen ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Right Hepatectomy ◽  
Liver Hanging Maneuver ◽  
Hanging Maneuver ◽  
Extended Right Hepatectomy

scholarly journals Conversion hepatectomy for advanced hepatocellular carcinoma after right portal vein transection and lenvatinib therapy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuki Ohya ◽  
Shintaro Hayashida ◽  
Akira Tsuji ◽  
Kunitaka Kuramoto ◽  
Hidekatsu Shibata ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Kinase Inhibitor ◽  
Sharp Decrease ◽  
Hepatic Function ◽  
Advanced Hepatocellular Carcinoma ◽  
Right Hepatectomy ◽  
Advanced Hcc ◽  
Extended Right Hepatectomy ◽  
The Right

Abstract Background Lenvatinib is a novel tyrosine kinase inhibitor that exhibits an antitumor effect on hepatocellular carcinoma (HCC). An established strategy that involves surgery and usage of lenvatinib for advanced HCC remains elusive. Case presentation A 58-year-old male patient with advanced HCC and untreated hepatitis B was referred to our hospital. The tumor at the right lobe was 10 cm in diameter with right portal vein thrombus. Because of the possible lung metastasis and concern about the remaining hepatic function after extended right hepatectomy, lenvatinib was initiated before surgery. After the confirmation of a sharp decrease of tumor markers during the 3-week lenvatinib therapy, only a right portal vein transection was done leaving the enlargement of the left lobe for improved post-hepatectomy liver function while lenvatinib therapy was continued. The laparotomy revealed that the tumor was invading the right diaphragm. After 7 weeks of lenvatinib administration after right portal vein transection, an extended right hepatectomy with resection of the tumor-invaded diaphragm was successfully done. The lung nodules that were suspected as metastases had disappeared. The patient has been doing well without any sign of recurrence for 1 year. Conclusion The strategy involving the induction of lenvatinib to conversion hepatectomy including the portal vein transection was effective for advanced HCC.

Extended Right Hepatectomy by Liver Hanging Maneuver in an Infant with Hepatoblastoma

2016 ◽  
Vol 8 (3) ◽  
pp. 411-413
Author(s):  
C. Ramachandra ◽  
Sharma Vikas ◽  
S. Krishnamurthy ◽  
S. Ramesh ◽  
L. Appaji ◽  
...  
Keyword(s):  
Right Hepatectomy ◽  
Liver Hanging Maneuver ◽  
Hanging Maneuver ◽  
Extended Right Hepatectomy
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