scholarly journals Subtotal (segment II–VIII) hepatectomy for bilateral diffuse hepatolithiasis with compensatory caudate lobe hypertrophy: a report of two cases

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei Wang ◽  
ZiJie Zhang ◽  
Jian Wang
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Comprehensive Evaluation ◽  
Preoperative Evaluation ◽  
Case Series ◽  
Operation Time ◽  
Caudate Lobe ◽  
Compensatory Response ◽  
Left And Right

Abstract Background Hepatolithiasis often leads to atrophy–hypertrophy complex due to bile duct obstruction, inflammation or infection in the affected liver segments and compensatory response in the normal segments. In severe bilateral diffuse cases, main liver can all be atrophic, leaving the caudate lobe to be extremely hypertrophic. Subtotal (segment II–VIII) hepatectomy can be an option in selected patients under such circumstances. Since rare cases have been reported, our study aims to highlight the preoperative evaluation and key points of this procedure. Case presentation Two patients with primary and secondary bilateral diffuse hepatolithiasis, respectively, were enrolled in this case series. The atrophy of the left and right liver with an exceeding hypertrophy of the caudate lobe were observed. Since the liver anatomy had completely been changed, contrast computed tomography, magnetic resonance imaging combined with 3D liver reconstruction were employed for comprehensive evaluation and pre-operational planning. The patients underwent standard subtotal (segment II–VIII) hepatectomy. During operation, the hepatoduodenal ligament around porta hepatis was dissected firstly to expose the hepatic artery, portal vein, bile duct and their branches successively. And then the vessels and bile duct to caudate lobe were preserved safely through cutting off the left and right hepatic artery, portal vein and bile duct at a safe point distal to the origin of the branches to caudate lobe. Operation time was 300 min and 360 min, respectively. Blood loss was 200 ml and 300 ml. No evidence of liver dysfunction, hepatolithiasis relapse or cholangitis was observed during the follow-up of 12 and 26 months. Conclusions Subtotal (segment II–VIII) hepatectomy may be one of several treatments possible in selected patients with compensatory caudate lobe hypertrophy caused by bilateral diffuse hepatolithiasis.

Combined portal vein, hepatic artery and bile duct injury during open cholecystectomy

2021 ◽  
Author(s):  
Narendra Pandit ◽  
Tek Narayan Yadav ◽  
Kunal Bikram Deo ◽  
Laligen Awale ◽  
Lokesh Shekher Jaiswal
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Bile Duct Injury ◽  
Open Cholecystectomy

Hepatic Resection Combined with Portal Vein or Hepatic Artery Reconstruction for Advanced Carcinoma of the Hilar Bile Duct and Gallbladder

2003 ◽  
Vol 27 (10) ◽  
pp. 1137-1142 ◽  
Author(s):  
Hiroshi Shimada ◽  
Itaru Endo ◽  
Mitsutaka Sugita ◽  
Hideki Masunari ◽  
Yoshiro Fujii ◽  
...  
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Hepatic Resection ◽  
Hepatic Artery ◽  
Advanced Carcinoma ◽  
Hepatic Artery Reconstruction ◽  
Hilar Bile Duct ◽  
Artery Reconstruction

scholarly journals Feasibility of delayed vascular repair after surgical combined injury to the bile duct and hepatic artery: case series and systematic review

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S787
Author(s):  
L.F. Grochola ◽  
C. Kuemmerli ◽  
V.L. Lopez ◽  
C. Oberkofler ◽  
R.R. Campos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bile Duct ◽  
Hepatic Artery ◽  
Case Series ◽  
Vascular Repair ◽  
Combined Injury

scholarly journals Application of Laparoscopic Radical Resection for Type III and IV Hilar Cholangiocarcinoma Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Sulai Liu ◽  
Xinyu Liu ◽  
Xuepeng Li ◽  
Ou Li ◽  
Weimin Yi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Blood Loss ◽  
Tumor Size ◽  
Hilar Cholangiocarcinoma ◽  
Preoperative Evaluation ◽  
Operation Time ◽  
Bile Leakage ◽  
Radical Resection ◽  
Operative Strategy ◽  
Type Iii

Background. This study is aimed at investigating the feasibility and safety of the laparoscopic radical resection for treating type III and IV hilar cholangiocarcinoma (III/IV Hilar C). Methods. Six patients with III/IV Hilar C were enrolled in our hospital. All patients underwent total laparoscopic surgery, including basic surgery (laparoscopic gallbladder, hilar bile duct, and common bile duct resection and hepatoduodenal ligament lymph node dissection) combined with left hepatic and caudate lobe resection/portal resection. The tumor size, operation time, intraoperative blood loss, and postoperative complications were observed. The follow-up of the patients after discharge was recorded. Results. Surgery was successfully completed in 6 patients. We found that the tumor size of 6 patients ranged from 1.5 to 3.6 cm, with 4 lymph nodes. The operation time was 540-660 minutes, and the blood loss was 300-500 ml. One patient developed bile leakage after surgery, healed within 2 weeks after drainage. The postoperative hospital stay was 16 (13-24) days. There were 4 cases of negative bile duct margin tumor, 1 case was positive, and 1 case was not reported. All 6 patients were discharged smoothly without perioperative death. Regular examinations were conducted every 3 months after discharge, and the median duration was 7 months. Only 1 patient had a marginal dysplasia, and 5 patients had no obvious signs of recurrence. Conclusions. Application of laparoscopic radical resection for III/IV Hilar C is safe and feasible and has good short-term efficacy with adequate preoperative evaluation, appropriate case selection, and precise operative strategy.

scholarly journals Teratoma arising from hepato duodenal ligament in the newborn with transection of portal vein, hepatic artery and common bile duct: A surgical challenge

2018 ◽  
Vol 23 (1) ◽  
pp. 45 ◽  
Author(s):  
VR Ravikumar ◽  
G Rajamani ◽  
Vijayakumar Raju ◽  
Rajani Sundar ◽  
Sowmya Ravikumar ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Portal Vein ◽  
Hepatic Artery

Handling of hilar vasculature in living donor right hepatectomy using extrahepatic Glissonean approach

2021 ◽  
Author(s):  
Naokazu Chiba ◽  
Motohide Shimazu ◽  
Shigeto Ochiai ◽  
Takahiro Gunji ◽  
Toshimichi Kobayashi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Living Donor ◽  
Donor Hepatectomy ◽  
Central Direction ◽  
Tissue Removal ◽  
Glissonean Approach ◽  
The Right ◽  
Living Donor Hepatectomy

Donor hepatectomy is one of the most important procedures in LDLT because it affects the safety of donors and the outcome of the recipients. We standardized a method of securing the important vessels at the hepatic hilum while advancing the dissection toward the central direction. This research introduces our technique of handling hilar vasculature in living donor hepatectomy, using the extrahepatic Glissonean approach, and discusses its efficacy. At first, after the extrahepatic right Glissonean approach, the resected hepatic artery and portal vein are secured on the same line as with the secured the glisson. The resected hepatic artery and portal vein are followed in the central direction, and the surrounding area is dissected. The dissection is continued up to the main brunch of hepatic artery and portal vein. The bile duct can be secured by subtracting the hepatic artery and portal vein from the tape that secured the Glissonean pedicle. The bile duct, hepatic artery, and the portal vein are dissected in this order, before dissecting the right hepatic vein, completing the surgery. This method of dissection approaching the extrahepatic Glisson is carried out towards the central direction suggest to acquire minimal tissue removal and to shorten operative time. This could result in adequate perfusion to the remaining liver and donor safety, taken together effective results on recipient.

scholarly journals Gross Anatomical Studies on the Portal Vein, Hepatic Artery and Bile Duct in the Liver of the Pig

2008 ◽  
Vol 1 (1) ◽  
pp. 59-72 ◽  
Author(s):  
F. Osman ◽  
Y. Wally ◽  
F. El-Nady ◽  
H. Rezk
Keyword(s):  
Bile Duct ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Anatomical Studies
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