Post-hepatectomy liver failure: Should we consider venous outflow?

Martin Lhuaire; Tullio Piardi; Onorina Bruno; Annie Sibert; Reza Kianmanesh; Daniele Sommacale

doi:10.1016/j.ijscr.2015.10.001

Post-hepatectomy liver failure: Should we consider venous outflow?

Int J Surg Case Rep. 2015:16:154-6. doi: 10.1016/j.ijscr.2015.10.001. Epub 2015 Oct 8.

Authors

Martin Lhuaire¹, Tullio Piardi², Onorina Bruno³, Annie Sibert³, Reza Kianmanesh², Daniele Sommacale²

Affiliations

¹ Department of General, Digestive and Endocrine Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France. Electronic address: martin.lhuaire@etudiant.univ-reims.fr.
² Department of General, Digestive and Endocrine Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France.
³ Department of Radiology, Hôpital Beaujon, Assistance Publique des Hôpitaux de Paris, Clichy, France.

Abstract

Introduction: Post-hepatectomy liver failure (PHLF) is one of the most serious complications of liver resection and is associated with high morbidity and mortality rates.

Presentation of case: We report a case of PHLF involving clinical presentation of posthepatectomy-related 'small-for-size' syndrome (SFSS) secondary to obstructed venous outflow in the liver remnant, following extended right hepatectomy.

Discussion: PHLF is similar to SFSS in liver transplantation (LT) in terms of pathogenesis, clinical presentation and outcomes. Although inflow hypertension is clearly implicated in the pathogenesis of SFSS some authors have suggested that outflow obstruction is a potential pathogenic factor.

Conclusion: The present case support the hypothesis that outflow obstruction could lead symptoms similar to SFSS.

Keywords: Hepatobiliary surgery; Interventional radiology; Post-hepatectomy liver failure; Small-for-size syndrome.