Right hepatic vein reconstruction in middle hepatectomy: A case report

Aijun Li; Bin Wu; Lei Yin; Xiaoyu Yang; Keji Cheng; Junwu Guo; Mengchao Wu

doi:10.1016/j.ijscr.2022.107188

Right hepatic vein reconstruction in middle hepatectomy: A case report

Int J Surg Case Rep. 2022 Jun:95:107188. doi: 10.1016/j.ijscr.2022.107188. Epub 2022 May 14.

Authors

Aijun Li¹, Bin Wu², Lei Yin², Xiaoyu Yang², Keji Cheng², Junwu Guo², Mengchao Wu²

Affiliations

¹ Eastern Hepatobiliary Surgery Hospital, Naval Medical University, 225 Changhai Road, Shanghai, China. Electronic address: ajlihappy@163.com.
² Eastern Hepatobiliary Surgery Hospital, Naval Medical University, 225 Changhai Road, Shanghai, China.

Abstract

Background: Surgical resection is the only treatment modality that ensures complete tumor removal in patients with liver tumors involving a major hepatic vein. Central hepatectomy is a challenging procedure that often result in large defect at the right hepatic vein, which is not amenable to suturing or end-to-end anastomosis. Meanwhile, good outflow reconstruction is essential for early postoperative recovery and long-term survival.

Methods: We describe a simple technique for reconstructing the right hepatic vein. The technique is an effective method for reconstructing large venous defects after the hepatic vein resection. Reconstruction of the right hepatic vein has the advantages of prevention of congestion in segments VI and VII.

Conclusions: This technique allows surgeons to reconstruct the hepatic vein without synthetic vascular grafts and cryopreserved veins.

Keywords: HCC (hepatocellular carcinoma); Inferior vena cava (IVC); Middle hepatic vein (MHV); Posthepatectomy liver failure (PHLF); Right hepatic vein (RHV); TACE (transcatheter arterial chemoembolization); Total hepatic vascular exclusion (THVE).