scholarly journals Partial Hepatectomy with Middle Hepatic Vein Reconstruction Using a Left Inferior Vena Cava Graft

2017 ◽  
Vol 11 (2) ◽  
pp. 320-328 ◽  
Author(s):  
Yusuke Kawamoto ◽  
Yusuke Ome ◽  
Kazuyuki Kawamoto
Keyword(s):  
Inferior Vena Cava ◽  
Partial Hepatectomy ◽  
Hepatic Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Future Liver Remnant ◽  
Middle Hepatic Vein ◽  
Venous Graft ◽  
Liver Remnant ◽  
Hepatic Vein Reconstruction

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. Therefore, partial hepatectomy with MHV resection was performed. The left IVC was harvested as a venous graft and was substituted for the resected MHV. She recovered uneventfully and was discharged on postoperative day 12. To the best of our knowledge, this is the first report of using the left IVC as a venous graft. The left IVC is a good candidate graft for the MHV or for portal vein reconstruction because of its length, diameter, and easy harvesting (it did not require an extra incision) in a patient with duplicated IVC.

scholarly journals A CASE OF EXTENDED LEFT LOBECTOMY WITH RESECTION OF THE INFERIOR VENA CAVA USING MIDDLE HEPATIC VEIN AS PATCH GRAFT

2004 ◽  
Vol 65 (1) ◽  
pp. 172-174
Author(s):  
Kazuyoshi YAMAMOTO ◽  
Junzo SHIMIZU ◽  
Seizo MASUTANI ◽  
Masayuki TATSUTA ◽  
Hideyuki ISHIDA ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Hepatic Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Middle Hepatic Vein ◽  
Left Lobectomy ◽  
Patch Graft

Short hepatic vein reconstruction in biliary atresia patients with absent inferior vena cava

2007 ◽  
Vol 21 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Ender Dulundu ◽  
Yasuhiko Sugawara ◽  
Junichi Kaneko ◽  
Yoji Kishi ◽  
Nobuhisa Akamatsu ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Biliary Atresia ◽  
Hepatic Vein ◽  
Inferior Vena ◽  
Vena Cava ◽  
Hepatic Vein Reconstruction

Surgical Resection of Tumors Invading the Inferior Vena Cava at the Hepatic Vein and Thoracic Levels

2021 ◽  
Author(s):  
Justin Issard ◽  
Antonio Sa Cunha ◽  
Dominique Fabre ◽  
Delphine Mitilian ◽  
Sacha Mussot ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Surgical Resection ◽  
Hepatic Vein ◽  
Inferior Vena ◽  
Vena Cava

Rescue partial ALPPS for left hemihepatectomy with reconstruction of the middle hepatic vein

2021 ◽  
Author(s):  
Masaharu Kogure ◽  
Takaaki Arai ◽  
Hirokazu Momose ◽  
Ryota Matsuki ◽  
Yutaka Suzuki ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Vein ◽  
Retention Rate ◽  
Liver Volume ◽  
Future Liver Remnant ◽  
Middle Hepatic Vein ◽  
Liver Remnant ◽  
Total Liver Volume ◽  
Left Hemihepatectomy ◽  
Icg R15

Major hepatectomy in patients with insufficient future liver remnant (FLR) volume and impaired liver functional reserve has considerable risks for posthepatectomy liver failure (PHLF). The patient was a male in his 70 with an intrahepatic cholangiocarcinoma (ICC) in left hemiliver, involving the middle hepatic vein (MHV). Although FLR volume after left hemihepatectomy was estimated to be 64.4% of the total liver volume, an indocyanine green retention rate at 15 min (ICG-R15) value was 24.2%, thus the patient underwent left portal vein embolization (PVE). The FLR volume increased to 71.3%, however, the non-congestive FLR volume was re-estimated as 45.8% after resection of the MHV, the ICG-R15 value was 29.0%, and ICG-Krem was calculated as 0.037. We performed partial rescue ALPPS (Associating Liver Partition and Portal vein occlusion for Staged hepatectomy) for left hemihepatectomy with the MHV reconstruction. On the first stage, partial liver partition was done along Rex-Cantlie’s line, preserving the MHV and sacrificing the remaining branches to segment 8. The FLR volume increased to 77.4% on day 14. The ICG-R15 value was 29.6%, but ICG-Krem after MHV reconstruction was estimated to be 0.059. The second stage operation on day 21 was left hemihepatectomy with the MHV reconstruction using the left superficial femoral vein graft. The usage of rescue partial ALPPS may contribute to preventing PHLF by introducing occlusion of the portal and/or venous branches in the left hemiliver before curative hepatectomy.

scholarly journals Regression of tumor thrombus in the suprahepatic vena cava of hepatocellular carcinoma and conversion hepatectomy induced by lenvatinib

Liver Cancer ◽  
2021 ◽  
Author(s):  
Ryota Matsuki ◽  
Naohiro Okano ◽  
Takaaki Arai ◽  
Shinya Yoshiike ◽  
Masaharu Kogure ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Hepatic Vein ◽  
Extracorporeal Circulation ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Advanced Hepatocellular Carcinoma ◽  
Conversion Surgery ◽  
First Case

Abstract Recent developments in systemic chemotherapy for advanced hepatocellular carcinoma have been outstanding. However, reports on conversion surgery after lenvatinib therapy are scarce. We present the first case of advanced hepatocellular carcinoma with tumor thrombus in the suprahepatic vena cava close to the right atrium, which shrank after 12 weeks’ administration of lenvatinib, thereby leading to successful conversion surgery without using total vascular exclusion or extracorporeal circulation. The treatment strategy for hepatocellular carcinoma with macroscopic hepatic vein tumor thrombus is controversial, however, from a Japanese nationwide survey, surgical resection has been accepted as one of the treatment options for advanced hepatocellular carcinoma with hepatic vein tumor thrombus in Japan. However, the survival rate after resection of hepatocellular carcinoma having inferior vena cava tumor thrombus with extracorporeal circulation was reported to be worse than without extracorporeal circulation, and some preoperative down-sizing therapy for inferior vena cava tumor thrombus was advocated. Preoperative lenvatinib therapy might be a promising option among the multidisciplinary treatments for hepatocellular carcinoma with macroscopic tumor thrombus in the hepatic veins.

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