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| Caudate lobe-sparing subtotal hepatectomy as treatment for extensive intrahepatic arterioportal fistula |
| Rui Tang, Guang-Dong Wu, Ang Li, Li-Han Yu, Xuan Tong, Jun Yan, Qian Lu ∗ |
Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Institute for Precision Medicine, Tsinghua University,
Beijing 102218, China
∗ Corresponding author.
E-mail address: luqian_lt@163.com (Q. Lu). |
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Abstract Intrahepatic arterioportal fistulas (APFs) are abnormal hepatic artery and portal vein (PV) communications that develop as a result of congenital malformation, trauma, ruptured hepatic aneurysm, cirrhosis, tumor-related changes, biopsy, chemotherapy or iatrogenic causes [1,2]. The most common symptoms are gastrointestinal bleeding and ascites secondary to portal hypertension; other symptoms include abdominal pain, pyrexia, edema, back pain and jaundice [3]. The main goal of therapy is to decrease the portal pressure with variceal bleeding being the absolute indication for surgical management. Transarterial embolization (TAE) should be the first choice to treat APFs, while resection, portocaval shunt and even transplantation may cure APFs in the case of TAE failure [4]. In previous reports, caudate lobe-sparing subtotal hepatectomy (CLSSH) has been applied for the treatment of primary hepatolithiasis and hepatocellular carcinoma [5,6]. As far as we know, this is the first report describing CLSSH as treatment for an extensive intrahepatic APF, which involved segments 2 to 8, with corresponding hypertrophy of the caudate lobe.
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2023, Vol. 22 
