Vascular reconstruction in hepatic surgery

Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
S HeinrichH Lang

Abstract

Due to their size or location liver tumors can infiltrate important vascular structures, which are essential for postoperative liver function. To present the technical possibilities and results of current concepts of vascular resection and reconstruction in liver surgery. A literature search of the Medline and Cochrane databases was performed regarding currently available studies on vascular resection and reconstruction in liver surgery. Portal vein resections are routinely performed by many institutions and can be performed as an end-to-end anastomosis or graft interposition. This is the basis of the en bloc resection concept, especially for Klatskin tumors. Reconstruction of the inferior vena cava as well as the hepatic arteries is technically feasible and is increasingly being reported in smaller series. In particular, the resection of tumors near the hepatic veins may require total vascular exclusion for complete interruption of liver perfusion, which enables resection in the non-perfused liver and by this reduced blood loss. Furthermore, in situ cooling, ante situm and ex situ resections increase both technical resectability and the ischemic tolerance of the liver to more than 60 min. The majority of vascular reconstructio...Continue Reading

References

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Citations

Nov 1, 2018·Future Oncology·Marcello DonatiKarl J Oldhafer
May 1, 2021·Journal of Clinical Medicine·Tim ReeseKarl J Oldhafer
Sep 15, 2021·Langenbeck's Archives of Surgery·Olga Radulova-MauersbergerCarina Riediger

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