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Treatment for accidental occlusion of the hepatic artery after hepatic resection: Report of two cases

Surgery Today volume 29, pages 268–272 (1999)Cite this article

Abstract

Two patients in whom accidental hepatic artery occlusion (HAO) occurred after hepatic resection (Hx) were reported. A 59-year-old female who underwent Hx for hepatocellular carcinoma with underlying liver cirrhosis developed HAO on postoperative day (POD) 14 and died of hepatic failure on POD 23. The autopsy findings showed multiple necrosis in the remnant liver and an extraluminal hematoma of the hepatic artery, suggesting an injury caused by Pringle’s maneuver. The second case was a 53-year-old male who underwent Hx for cholangiocarcinoma without any underlying liver disease. He developed HAO on POD 6, and radiological studies indicated a pseudoaneurysma formation and severe stenosis of the hepatic artery. It was speculated that the cause of the HAO was intraluminal injury of the hepatic artery during an angiographic study conducted prior to Hx. Partial arterialization of the portal vein was performed, following which his liver function test results improved. In both cases, measuring the serum hepatocyte growth factor level and the hepatic vein oxygen saturation proved useful, not only for determining the degree of liver injury, but also for predicting the outcome after treatments for HAO. Furthermore, the partial arterialization of the portal vein for HAO after Hx may rescue the normal remnant liver.

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Affiliations

  1. First Department of Surgery, Kagoshima University, School of Medicine, 8-35-1 Sakuragaoka, 890, Kagoshima, Japan

    Gen Tanabe, Kouichi Kawaida, Masahiro Hamanoue, Kenji Kihara, Shingo Hirata, Makoto Maemura, Shinichi Ueno & Takashi Aikou

Authors
  1. Gen Tanabe
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  2. Kouichi Kawaida
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  3. Masahiro Hamanoue
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  4. Kenji Kihara
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  5. Shingo Hirata
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  6. Makoto Maemura
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  7. Shinichi Ueno
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  8. Takashi Aikou
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Tanabe, G., Kawaida, K., Hamanoue, M. et al. Treatment for accidental occlusion of the hepatic artery after hepatic resection: Report of two cases. Surg Today 29, 268–272 (1999). https://doi.org/10.1007/BF02483020

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  • DOI: https://doi.org/10.1007/BF02483020

Key Words

  • hepatic artery occlusion
  • hepatic resection
  • hepatocyte growth factor
  • hepatic vein oxygen saturation
  • arterialization