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Approach to the Porta Hepatis During Cytoreductive Surgery: Technical Considerations

  • Gastrointestinal Oncology
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Abstract

Peritoneal carcinomatosis has until recently been considered uniformly fatal; it results in intestinal obstructions, eventually leading progression of disease and death. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy have become important options for patients with peritoneal carcinomatosis. Completeness of cytoreduction is a major determinant of survival. Frequently, the porta hepatis and the lesser sac are massively involved by tumor. Encasement of portal triad, lesser omentum, retrohepatic vena cava, duodenum, and stomach is frequently seen. The proximity to major portal structures as well as the retrohepatic vena cava makes this dissection challenging. This is the area where meticulous surgical technique and expertise are necessary to obtain complete removal of tumor. Some specific technical considerations are important to assure that all tumor is safely removed.

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Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgical Oncology, Institute for Cancer Care, Mercy Medical Center, Baltimore, MD, USA

    N. Aydin MD, FACS, A. Sardi MD, FACS & V. Milovanov MD

Authors
  1. N. Aydin MD, FACS
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  2. A. Sardi MD, FACS
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  3. V. Milovanov MD
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Corresponding author

Correspondence to A. Sardi MD, FACS.

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Aydin, N., Sardi, A. & Milovanov, V. Approach to the Porta Hepatis During Cytoreductive Surgery: Technical Considerations. Ann Surg Oncol 23, 552–555 (2016). https://doi.org/10.1245/s10434-015-4872-x

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  • DOI: https://doi.org/10.1245/s10434-015-4872-x

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