Vessel Reconstruction for Great Vessel Invasion by Hepatobiliary Malignancy

Guo-Shiou Liao ； Huan-Fa Hsieh ； Chung-Bao Hsieh ； Teng-Wei Chen ； Cheng-Jueng Chen ； Jyh-Cherng Yu ； Yao-Chi Liu

《Journal of Medical Sciences》 25卷6期 (2005/12) Pp. 309-312

並列摘要

Tumor invasion of the portal vein and inferior vena cava (IVC) by hepatic malignancy is usually considered to be unresectable. Recent advances in hepatic surgery have made combined resection of the liver and hepatic great vessels possible. We present two cases to describe the surgical techniques for the repair of the IVC and portal vein. One patient with cholangiocarcinoma invasion of the portal vein underwent extended left liver lobectomy with reconstruction of the portal vein using a hepatic venous patch. The patch was harvested from the hepatic vein of the resected portion of liver. Another patient with hepatocellular carcinoma invasion of the IVC and diaphragm had a partial hepatectomy and the IVC was reconstructed with a prosthetic graft patch. At 12 and 14 months follow-up, the two patients remain alive and apparently disease-free without evidence of IVC or portal vein occlusion. Combined resection of the liver and hepatic great vessels is a formidable undertaking with substantial surgical risk. However, this aggressive surgical approach offers a chance for cure in patients with tumors involving the hepatic great vessels that would otherwise have a dismal prognosis.

並列關鍵字

inferior vena cava ； portal vein ； reconstruction