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| 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). |
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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.
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| [1] |
Mazzarella G, Muttillo EM, Coletta D, Picardi B, Rossi S, Rossi Del Monte S, Gomes V, Muttillo IA. Solid pseudopapillary tumor of the pancreas: A systematic review of clinical, surgical and oncological characteristics of 1384 patients underwent pancreatic surgery[J]. Hepatobiliary Pancreat Dis Int, 2024, 23(4): 331-338. |
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2024, Vol. 23 
