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Porto-Rex Shunt for Left Portal Vein Reconstruction During Right Extended Hepatectomy for Advanced Extrahepatic Biliary Cancer

  • Eylon Lahat
  • Ahmad Jaber
  • Chady Salloum
  • Chetana Lim
  • Gil Golan
  • Ziv Ben-Ari
  • Mordechai Gutman
  • Daniel AzoulayEmail author
Innovative Surgical Techniques Around the World

Abstract

Resection offers the only chance of long-term survival or cure for perihilar cancer, provided R0 resection is achieved with margin-negative status of the remnant liver, bile duct, proximal hepatic artery, and portal vein. End-to-end anastomosis of the portal trunk to the left portal branch is the conventional portal reconstruction in cases of right extended hepatectomy requiring resection of the portal vein bifurcation. This mandatory reconstruction may be challenging due to (1) vessel incongruence, (2) fragility of the left portal branch wall, and more importantly, and (3) the divergent orientation of the two vessels exposing to vascular twisting/kinking. We report here the first two cases of porto-Rex shunt, between the portal vein trunk and the left portal vein in the umbilical fissure during right extended hepatectomy for advanced extrahepatic biliary cancer: one following failed conventional portal reconstruction and one to achieve macroscopically complete resection.

Notes

Compliance with ethical standards

Conflict of interest

None to declare.

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Eylon Lahat
    • 1
  • Ahmad Jaber
    • 1
  • Chady Salloum
    • 2
  • Chetana Lim
    • 2
  • Gil Golan
    • 3
  • Ziv Ben-Ari
    • 4
  • Mordechai Gutman
    • 1
  • Daniel Azoulay
    • 1
    • 2
    Email author
  1. 1.Department of General Surgery and Transplantation, Hepatobiliary and Pancreatic SurgeryTel Hashomer HospitalTel AvivIsrael
  2. 2.Department of Hepatobiliary and Pancreatic Surgery and Liver TransplantationHenri Mondor HospitalCréteilFrance
  3. 3.Department of RadiologyTel Hashomer HospitalTel AvivIsrael
  4. 4.Department of HepatologyTel Hashomer HospitalTel AvivIsrael

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