Hepatic vein reconstruction during hepatectomy: A feasible and underused technique
Manish Ahuja a , Kunal Joshi a , Chris Coldham a , Paulo Muiesan a , Bobby Dasari a , Manuel Abradelo a , Ravi Marudanayagam a , Darius Mirza a , John Isaac a , David Bartlett a , Nikolaos A Chatzizacharias a , Robert P Sutcliffe a , Keith J Roberts a , b , ∗
a Department of HPB and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
b Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
∗ Corresponding author at: 3rd Floor Nuffield House, Department of HPB and Liver Transplant Surgery Queen Elizabeth Hospital, Edgbaston, Birmingham B15
2TH, UK.
E-mail address: keith.roberts@uhb.nhs.uk (K.J. Roberts).
Abstract：Complete surgical resection (R0) of liver tumors, primary or metastatic, remains the main objective in management of primary and metastatic liver tumors [1]. Tumors invading to the proximity of the hepatic venous outflow pose a peculiar challenge to achieve R0 resections, because this location may render a tumor unresectable. The median survival of patients with liver tumor without surgery is less than 12 months [2]. Even with surgery, post-hepatectomy liver failure and subsequently increased mortality are the main problems associated with complex resection [3]. Moreover, when the vein is affected, vein resection and subsequent reconstruction are necessary. Vascular resection is a standard practice in liver resection and transplantation [4], for example, hepatic vein reconstruction during a living-donor liver transplant, porto-mesenteric axis reconstruction during resection of advanced pancreatic cancer and caval reconstruction during resection of retroperitoneal tumors. Thus, novel techniques like total hepatic vascular exclusion (HVE) [5], veno-venous bypass [6] and ex vivo hepatic resection [7,8] have facilitated curative resections of tumors close to one or more major hepatic veins.
引用本文:
. [J]. Hepatobiliary Pancreat Dis Int, 2024, 23(4): 421-427.
Ahuja M, Joshi K, Coldham C, Muiesan P, Dasari B, Abradelo M, Marudanayagam R, Mirza D, Isaac J, Bartlett D, Chatzizacharias NA, Sutcliffe RP, Roberts KJ. Hepatic vein reconstruction during hepatectomy: A feasible and underused technique. Hepatobiliary Pancreat Dis Int, 2024, 23(4): 421-427.
2024, Vol. 23 
