Reconstruction of hepatic veins in liver resection. Technique and possibility of prophylaxis of posthepatectomy liver failure

Alikhanov, Ruslan; Kubishkin, V. A.; Dubrovskiy, A. V.; Ефанов, Михаил

doi:10.17116/hirurgia2016356-58

Cited by 4 publications

(1 citation statement)

References 4 publications

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“…This is because of the poor prognosis, and the technical difficulties and risks of resection of multiple vessels involved in tumor infiltration. The main goal of tumor surgery is to achieve complete tumor clearance while ensuring patients’ safety ( 9 ). The resectability of liver tumors has increased due to the continuous development of new adjuvant treatment modalities and new surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

First Robotic Hepatectomy With Middle Hepatic Vein Reconstruction Using ePTFE Graft for Hepatic Adenoma: A Case Report

Wang

Jin

et al. 2022

Front. Surg.

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Surgical resection remains the best choice for the treatment of liver tumors. Hepatectomy combined with artificial vascular reconstruction has been proven as an alternative to treating tumors involving the main hepatic veins. As the cutting-edge surgical technique, robotic liver surgery is a novel procedure expanding the field of minimally invasive approaches, especially in complex reconstruction. This study reports, for the first time, on a robotic hepatectomy with middle hepatic vein (MHV) reconstruction using an expanded polytetrafluoroethylene (ePTFE) graft for a patient with hepatic adenoma. The tumor, which was located in segment 8, was adjacent to the MHV. Robot-assisted resection of segment 4 and partial segment 8, and MHV reconstruction using a ePTFE graft were performed. During the post-operative examination and follow-up, the blood flow of the ePTFE graft was patent, and liver function recovered well. Thus, robotic hepatectomy with MHV reconstruction is a safe, minimally invasive, and precise surgery that may provide a novel approach for patients with liver tumors that are invading or adjacent to the main hepatic veins.

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Section: Discussionmentioning

confidence: 99%

First Robotic Hepatectomy With Middle Hepatic Vein Reconstruction Using ePTFE Graft for Hepatic Adenoma: A Case Report

Wang

Jin

et al. 2022

Front. Surg.

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Transplantation techniques in surgery for locally advanced liver tumors (review)

2019

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Совершенствование диагностики, хирургических технологий, методов анестезии и интенсивной терапии привело к существенному уменьшению летальности после резекций печени. Более 30 лет эти показатели остаются неизменными и не превышают 5% при отсутствии существенных факторов риска. Мало меняется и частота осложнений, не превышающая 50%, что также

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Resecting liver segments VII–VIII without reconstructing the right hepatic vein

et al. 2022

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Aim. To improve outcomes of treatment for neoplasms in segments VII-VIII of the liver adjacent to the main stem of the right hepatic vein and/or to its forming large branches.Materials and methods. In the period of 2016–2022, the resection of segments VII and/or VIII of the liver and the right hepatic vein, as well as its forming branches without reconstruction was performed in 24 patients. Surgical indications were liver metastases of colorectal cancer in 15 cases, hepatocellular cancer (cholangiocarcinoma) in six cases, angiomyolipoma in one case, uterine cancer metastases in one case and primary retroperitoneal tumor metastases in one case. Minor liver resections were additionally performed in 11 cases. Results. There were no intraoperative signs of impaired venous drainage. After surgery bile in the drains was detected in three patients, and a biliary fistula was formed in one case. No other complications were identified. No fatalities were registered after surgery. The late postoperative period revealed no specific complications related to a disturbance of venous drainage through the right hepatic vein.Conclusion. Existing and emerging collaterals can provide adequate venous drainage to the middle hepatic vein, short hepatic veins after resection of liver segments VII and VIII with resection of the right hepatic vein stem and its forming branches without reconstruction, even if the lower right hepatic vein is missing, and without complete obstruction of the right hepatic vein before surgery.

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Reconstruction of hepatic veins in liver resection. Technique and possibility of prophylaxis of posthepatectomy liver failure

Abstract: Reconstruction of hepatic veins allow to safely perform radical parenchyma-preserving liver resection in patients with compromised liver function due to liver cirrhosis, fibrosis or steatosis.

Cited by 4 publications

References 4 publications

First Robotic Hepatectomy With Middle Hepatic Vein Reconstruction Using ePTFE Graft for Hepatic Adenoma: A Case Report

First Robotic Hepatectomy With Middle Hepatic Vein Reconstruction Using ePTFE Graft for Hepatic Adenoma: A Case Report

Transplantation techniques in surgery for locally advanced liver tumors (review)

Resecting liver segments VII–VIII without reconstructing the right hepatic vein

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