Abstract
Liver resections that require ex vivo techniques occur rarely, but when done are generally performed on veno-veno bypass to maintain venous return and decompress the portal circulation during the anhepatic phase of the procedure. We describe an ex vivo extended left hepatectomy that was performed with preservation of the inferior vena cava and the use of a temporary portacaval shunt to eliminate the need for veno-venous bypass. Ex vivo resection allowed reconstruction of right hepatic vein branches, using the patient's reversed portal vein bifurcation as a graft to provide venous outflow.
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R Pichlmayr HJ Bretschneider E Kirchner B Ringe P Lamesch G Gubernatis et al. (1988) ArticleTitleEx situ operation on the liver. A new possibility in liver surgery Langenbecks Arch Chir 373 122–6 Occurrence Handle3287072 Occurrence Handle1:STN:280:BieB3s3gs1I%3D Occurrence Handle10.1007/BF01262775
KJ Oldhafer H Lang HJ Schlitt J Hauss R Raab J Klempnauer et al. (2000) ArticleTitleLong-term experience after ex situ liver surgery Surgery 127 520–7 Occurrence Handle10819060 Occurrence Handle1:STN:280:DC%2BD3c3nvFSgsA%3D%3D Occurrence Handle10.1067/msy.2000.105500
JP Lodge BJ Ammori KR Prasad MC Bellamy (2000) ArticleTitleEx vivo and in situ resection of inferior vena cava with hepatectomy for colorectal metastases Ann Surg 231 471–9 Occurrence Handle10749606 Occurrence Handle1:STN:280:DC%2BD3c3htlaisg%3D%3D Occurrence Handle10.1097/00000658-200004000-00004
R Raab HJ Schlitt KJ Oldhafer A Bornscheuer H Lang R Pichlmayr (2000) ArticleTitleEx-vivo resection techniques in tissue-preserving surgery for liver malignancies Langenbecks Arch Surg 385 179–84 Occurrence Handle10857488 Occurrence Handle1:STN:280:DC%2BD3cvptl2ruw%3D%3D Occurrence Handle10.1007/s004230050262
AW Hemming RS Chari MS Cattral (2000) ArticleTitleEx vivo liver resection Can J Surg 43 222–4 Occurrence Handle10851418 Occurrence Handle1:STN:280:DC%2BD3czgvF2ltQ%3D%3D
AW Hemming MS Cattral (1999) ArticleTitleEx vivo liver resection with replacement of the inferior vena cava and hepatic vein replacement by transposition of the portal vein J Am Coll Surg 189 523–6 Occurrence Handle10549741 Occurrence Handle1:STN:280:DC%2BD3c%2FhsF2gtg%3D%3D Occurrence Handle10.1016/S1072-7515(99)00192-1
AW Hemming AI Reed MR Langham S Fujita WJ Van der Werf RJ Howard (2002) ArticleTitleHepatic vein reconstruction for resection of hepatic tumors Ann Surg 235 850–8 Occurrence Handle12035042 Occurrence Handle10.1097/00000658-200206000-00013
L Hannoun L Delriviere P Gibbs D Borie JC Vaillant E Delva (1996) ArticleTitleMajor extended hepatic resections in diseased livers using hypothermic protection: preliminary results from the first 12 patients treated with this new technique J Am Coll Surg 183 597–605 Occurrence Handle8957462 Occurrence Handle1:STN:280:ByiC3MnjslA%3D
AW Hemming AI Reed MR Langham SuffixJr S Fujita RJ Howard (2004) ArticleTitleCombined resection of the liver and inferior vena cava for hepatic malignancy Ann Surg 239 712–9 Occurrence Handle15082976 Occurrence Handle10.1097/01.sla.0000124387.87757.eb
T Yagyu R Shimizu M Nishida K Nakashima T Uchiyama T Suzuki (1994) ArticleTitleReconstruction of the hepatic vein to the prosthetic inferior vena cava in right extended hemihepatectomy with ex situ procedure Surgery 115 740–4 Occurrence Handle8197568 Occurrence Handle1:STN:280:ByuB2MrovVE%3D
K Yanaga K Kishikawa M Shimada S Kakizoe H Higashi T Nishizaki et al. (1993) ArticleTitleExtracorporeal hepatic resection for previously unresectable neoplasms Surgery 113 637–43 Occurrence Handle8506521 Occurrence Handle1:STN:280:ByyB1c7psVQ%3D
Y Kaneoka A Yamaguchi M Isogai A Hori (2000) ArticleTitleHepatic vein reconstruction by external iliac vein graft using vascular clips World J Surg 24 377–82 Occurrence Handle10658076 Occurrence Handle1:STN:280:DC%2BD3c7is1Cgug%3D%3D Occurrence Handle10.1007/s002689910060
S Nakamura S Sakaguchi T Hachiya S Suzuki R Nishiyama H Konno et al. (1993) ArticleTitleSignificance of hepatic vein reconstruction in hepatectomy Surgery 114 59–64 Occurrence Handle8356528 Occurrence Handle1:STN:280:ByyA283gslM%3D
K Kubota M Makuuchi Y Sugawara Y Midorikawa Y Sakamoto T Takayama et al. (1998) ArticleTitleReconstruction of the hepatic and portal veins using a patch graft from the right ovarian vein Am J Surg 176 295–7 Occurrence Handle9776163 Occurrence Handle1:STN:280:DyaK1cvkslSmug%3D%3D Occurrence Handle10.1016/S0002-9610(98)00149-4
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Hemming, A., Reed, A. & Fujita, S. Ex vivo extended left hepatectomy with caval preservation, temporary portacaval shunt, and reconstruction of the right hepatic vein outflow using a reversed portal vein bifurcation graft. J Hepatobiliary Pancreat Surg 13, 525–529 (2006). https://doi.org/10.1007/s00534-006-1101-9
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DOI: https://doi.org/10.1007/s00534-006-1101-9