Reconstruction of the hepatic vein to the prosthetic inferior vena cava in right extended hemihepatectomy with ex situ procedure.
Reconstruction of the hepatic vein to the prosthetic inferior vena cava in right extended hemihepatectomy with ex situ procedure.
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发表时间：
1994-06
期刊：
影响因子：
3.8
通讯作者：
T. Yagyu;R. Shimizu;M. Nishida;K. Nakashima;T. Uchiyama;T. Suzuki
中科院分区：
文献类型：
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作者：
T. Yagyu;R. Shimizu;M. Nishida;K. Nakashima;T. Uchiyama;T. Suzuki
异位手术可以完全切除涉及三条主要肝静脉汇合的肿瘤，这在使用常规技术时是困难的。方法我们报告了1例肝内胆管细胞癌患者，涉及三条主要肝静脉和肝后下腔静脉（IVC）的汇合，采用右半肝扩大切除术和异位肝后下腔静脉切除术。重建左肝静脉需要吻合左肝静脉和聚四氟乙烯（PTFE）替代IVC。据我们所知，这是第一次报告的重建肝静脉使用聚四氟乙烯假体。结果在体外肝手术中成功完成了肝左静脉与PTFE人工血管的吻合。患者自手术后8个月内未复发。肝静脉和移植物均未发生扭转或阻塞。结论在体外肝手术中重建肝静脉主干及PTFE人工血管替代下腔静脉可提高常规手术不能切除的肝癌的治愈率和切除率。
BACKGROUND Ex situ procedure permits complete resection of a tumor involving the confluence of the three main hepatic veins, which is difficult when conventional technique is used. METHODS We report treatment of a patient with intrahepatic cholangiocellular carcinoma involving this confluence of the three main hepatic veins and the retrohepatic inferior vena cava (IVC) by using right extended hemihepatectomy and resection of the retrohepatic IVC with ex situ procedure. Reconstruction of the left hepatic vein required anastomosis of the left hepatic vein and a polytetrafluoroethylene (PTFE) replacement for the IVC. To our knowledge this is the first report of reconstruction of the hepatic vein by use of a PTFE prosthesis. RESULTS Anastomosis of the left hepatic vein to the PTFE graft was successfully performed during extracorporeal liver operation. The patient has had no recurrence during 8 months since the operation. Neither torsion nor obstruction of the hepatic vein and the graft has been observed. CONCLUSIONS Reconstruction of main hepatic veins and the PTFE graft as the replacement of the IVC under extracorporeal liver operation may be useful in improving the cure rate and resection rate for liver cancer that is unresectable by the conventional technique.