Hepatic vein reconstruction during hepatectomy: A feasible and underused technique.
Ahuja, Manish Joshi, Kunal Coldham, Chris Muiesan, Paulo Dasari, Bobby Abradelo, Manuel Marudanayagam, Ravi Mirza, Darius Isaac, John Bartlett, David
Ahuja, Manish
Joshi, Kunal
Coldham, Chris
Muiesan, Paulo
Dasari, Bobby
Abradelo, Manuel
Marudanayagam, Ravi
Mirza, Darius
Isaac, John
Bartlett, David
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Publication date
2024-01-15
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Abstract
Background
Hepatic vein involvement can be a contraindication to resection of liver tumours. This study aimed to assess the feasibility, long term outcomes and vein patency among patients who underwent hepatic vein reconstruction during liver resections for liver tumour(s).
Methods
Retrospective analysis of patients who underwent circumferential hepatic venous reconstruction identified from a prospectively maintained database. Standard volumetric analysis was performed using software to estimate volumetry with and without hepatic venous reconstruction. Long term vein patency was established using review of available radiology.
Results
15 patients underwent 17 venous reconstructions for colorectal liver metastases (n=13), cholangiocarcinoma (n=1) and hepatocellular carcinoma (n=1). The median FLR without and with venous reconstruction were 32 (range 18.0-74.5) and 96% (range 26.9-97.7) respectively; the median increase in FLR was 34% per patient. Venous patency was 89% at a median follow-up of 25 months (Range 1-53) with 2 graft thrombosis. No patient developed PHLF.
Conclusions
Hepatic venous reconstruction during liver resection is safe and feasible. It has the potential to expand the scope of liver resection and preserve liver and venous drainage if needed in the future.
Citation
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 Aug;23(4):421-427. doi: 10.1016/j.hbpd.2024.01.002.
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