Modified ante situm liver resection without use of cold perfusion nor veno-venous bypass for treatment of hepatic lesions infiltrating the hepatocaval confluence

Langenbeck's Archives of Surgery
F OldhaferH Bektas

Abstract

Treatment of malignancies invading the hepatic veins/inferior vena cava is a surgical challenge. An ante situm technique allows luxation of the liver in front of the situs to perform tumor resection. Usually, cold perfusion and veno-venous bypass are applied. Our experience with modified ante situm resection relying only on total vascular occlusion is reported. Retrospective analysis on an almost 15-year experience with ante situm resection without application of cold perfusion or veno-venous bypass RESULTS: The ante situm technique was applied on eight patients. Five individuals were treated due to intrahepatic cholangiocellular cancer and one case each for mixed cholangio-/hepatocellular carcinoma, colorectal liver metastasis, and pheochromocytoma. Trisectorectomy (n = 4), left hemihepatectomy, right hepatectomy, atypical resection, or mesohepatectomy (each n = 1) were performed, combined with dissection of suprahepatic/retrohepatic vena cava/hepatic veins. Venous reconstruction was achieved by reimplantation of hepatic veins with/without vascular replacement using allogeneic donor veins or PTFE grafts. Median total vascular occlusion of the liver was 23 min. Severe morbidity occurred in three patients (Dindo-Clavien > 3A). R...Continue Reading

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Citations

Sep 27, 2020·Langenbeck's Archives of Surgery·Maria Baimas-GeorgeDionisios Vrochides
Jun 12, 2019·Langenbeck's Archives of Surgery·Mohammad H Fard-AghaieKarl J Oldhafer
Feb 17, 2021·Langenbeck's Archives of Surgery·Maria Baimas-GeorgeDionisios Vrochides
Feb 3, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Nikolaos MachairasGeorgios C Sotiropoulos
Mar 18, 2021·World Journal of Surgery·Nikola VladovVentsislav Mutafchiyski
Apr 8, 2021·The British Journal of Surgery·U CilloE Gringeri
May 1, 2021·Journal of Clinical Medicine·Tim ReeseKarl J Oldhafer
Aug 8, 2021·Cancers·Roberta AngelicoTommaso Maria Manzia
Sep 15, 2021·Langenbeck's Archives of Surgery·Olga Radulova-MauersbergerCarina Riediger

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