Hepatic vein reconstruction during hepatectomy: A feasible and underused technique.
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Author
Ahuja, ManishJoshi, Kunal
Coldham, Chris
Muiesan, Paulo
Dasari, Bobby
Abradelo, Manuel
Marudanayagam, Ravi
Mirza, Darius
Isaac, John
Bartlett, David
Chatzizacharias, Nikolaos A
Sutcliffe, Robert P
Roberts, Keith J
Publication date
2024-01-15
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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.Type
ArticlePMID
38278672Publisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.hbpd.2024.01.002