Combined resection of liver and inferior vena cava

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It was analyzed the results of treatment of 8 patients. Combined resection of liver and inferior vena cava was done in all cases. All resections of inferior vena cava were performed in combination with right-sided hemihepatectomy. Circular resection of inferior vena cava was done in 6 cases, tangential-in 2 cases. Allograft of donor inferior vena cava was used in 3 cases for reconstruction of inferior vena cava. Average duration of combined resection of liver and inferior vena cava was 675±189 min, average hemorrhage - 1800±1402 ml. The need for transfusion of packed red blood cells was 270±723 ml, the need for transfusion of fresh frozen plasma was 1105±636 ml. Post-resection liver failure according to criteria ISGLS developed in 3 patients (37.5%). Biliary complications such as biliary fistula and inconsistency of hepatico-jejunal anastomosis developed in 2 patients (25%). Hospital mortality was 12.5%. It is considered that resection of liver with inferior vena cava demands an experience in hepatobiliary surgery and/or liver transplantation. Surgeon must be ready to use total vascular isolation, hypothermic preservation and veno-venous bypass grafting. It allows to dilate an opportunity of resection liver surgery.

Keywords:

liver resection

resection of inferior vena cava

vascular isolation of liver

venous allograft

hypothermic preservation

Authors:

Shcherba A.E.

Gorodskaia klinicheskaia bol'nitsa #9 i Respublikanskiĭ nauchno-prakticheskiĭ tsentr transplantatsii organov i tkaneĭ, Minsk, Respublika Belarus'

Efimov D.Iu.

Gorodskaia klinicheskaia bol'nitsa #9 i Respublikanskiĭ nauchno-prakticheskiĭ tsentr transplantatsii organov i tkaneĭ, Minsk, Respublika Belarus'

Rummo O.O.

Gorodskaia klinicheskaia bol'nitsa #9 i Respublikanskiĭ nauchno-prakticheskiĭ tsentr transplantatsii organov i tkaneĭ, Minsk, Respublika Belarus'

List of references:

Shcherba А.E., Kirkovskij L.V., Dzyadz'ko А.M., Аvdej E.L., Minov А.F., Rummo O.O. Rezektsiya pecheni v usloviyakh gipotermicheskoj konservatsii [Liver resection under hypothermic preservation]. Novosti khirurgii 2012; 20: 6: 45-52. (in Russian)
Alighieri Mazziotti, Antonino Cavallari, Broelsch C., Belghiti J., Moreno González E., Hannoun L., Makuuchi M., Tzakis A.G. Techniques in Liver Surgery (Greenwich Medical Media) 1997; [Hardcover] Pages: 392.
Arii S., Teramoto K., Kawamura T., Takamatsu S., Sato E., Nakamura N., Iwai T., Mori A., Tanaka J., Imamura M. Significance of hepatic resection combined with inferior vena cava resection and its reconstruction with expanded polytetrafluoroethylene for treatment of liver tumors. J Am Coll Surg 2003; 196: 2: 243-249.
Aoki T., Sugawara, Imamura Y., Seyama H., Minagawa Y., Hasegawa M., Kokudo K., Makuuchi N.M. Hepatic resection with reconstruction of the inferior vena cava or hepatic venous confluence for metastatic liver tumor from colorectal cancer. J Am Coll Surg 2004; 198: 3: 366-372.
Beller S., Eulenstein S., Lange T., Niederstrasser M., Hunerbein M., Schlag P. A new measure to assess the difficulty of liver resection Eur J Surg Oncol 2009; 35: 1: 59-64.
Belzer F.O., Southard J.H. Principles of solid-organ preservation by cold storage. Transplantation 1988; 45: 4: 673-676.
Bismuth H., Castaing D., Garden O.J. Major hepatic resection under total vascular exclusion. Ann Surg 1989; 210: 1: 13-19.
Capussotti L., Polastri R. Operative risks of major hepatic resections. Hepatogastroenterology 1998; 45: 19: 184-190.
De Santibanes E. Ardiles, Alvarez V., Pekolj F.A., Brandi J., Beskow C.A. Hepatic artery reconstruction first for the treatment of hilar cholangiocarcinoma bismuth type IIIB with contralateral arterial invasion: a novel technical strategy. HPB (Oxford) 2012; 14: 1: 67-70.
Delis S.G., Madariaga J., Ciancio G. Combined liver and inferior vena cava resection for hepatic malignancy. J Surg Oncol 1996; 96: 3: 258-264.
Eberl T., Schmid T., Hengster P., Wodlinger R., Oberhuber G., Weiss H., Herold M., Waldenberger F., Margreiter R. Protective effects of various preservation solutions on cultured endothelial cells." Ann Thorac Surg 1994; 58: 2: 489-495.
Guerrero M.A., Cross C.A., Lin P.H., Keane T.E., Lumsden A.B. Inferior vena cava reconstruction using fresh inferior vena cava allograft following caval resection for leiomyosarcoma: midterm results. J Vasc Surg 2007; 46: 1: 140-143.
Hashimoto T., Minagawa M., Aoki T., Hasegawa K., Sano K., Imamura H., Sugawara Y., Makuuchi M., Kokudo N. Caval invasion by liver tumor is limited. J Am Coll Surg 2008; 207: 3: 383-392.
Hawkins W.G., DeMatteo R.P., Cohen M.S., Jarnagin W.R., Fong Y. D'Angelica, Gonen M., Blumgart M. Caudate hepatectomy for cancer: a single institution experience with 150 patients. J Am Coll Surg 2005; 200: 3: 345-352.
Hemming A.W., Reed A.I., Langham M.R. Jr., Fujita S., Howard R.J. Combined resection of the liver and inferior vena cava for hepatic malignancy. Ann Surg 2004; 239: 5:712-719; discussion 719-721.
Hemming A.W., Mekeel K.L., Zendejas I.K., Sicklick R.D., Reed J.K., Resection A.I. of the liver and inferior vena cava for hepatic malignancy. J Am Coll Surg 2007; 217: 1: 115-124; discussion 124-115.
Hoti E., Salloum C., Azoulay D. Hepatic resection with in situ hypothermic perfusion is superior to other resection techniques. Dig Surg 2011; 28: 2: 94-99. doi: 10.1159/000323817. Epub 2011 Apr 29.
Huguet C., Nordlinger B., Galopin J.J., Bloch P., Gallot D. Normothermic hepatic vascular exclusion for extensive hepatectomy. Surg Gynecol Obstet 1978; 147: 5: 689-693.
Jarnagin W.R., Gonen M., Fong Y., DeMatteo R.P., Ben-Porat L., Little S., Corvera C., Weber S., Blumgart L.H. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg 2002; 236: 4: 397-406; discussion 406-407.
Johnson S., Blitz T., Kneteman M., Bigam N. Combined hepatic and inferior vena cava resection for colorectal metastases. J Gastrointest Surg 2006; 10: 2: 220-226.
Kooby D.A., Stockman J., Ben-Porat L., Gonen M., Jarnagin W.R., Dematteo R.P., Tuorto S., Wuest D., Blumgart L.H., Fong Y. Influence of transfusions on perioperative and long-term outcome in patients following hepatic resection for colorectal metastases. Ann Surg 2003; 237: 6: 860-869; discussion 869-70.
Malde D., Khan J., Prasad K.R., Toogood G.J., Lodge J.P. Inferior vena cava resection with hepatectomy: challenging but justified. HPB (Oxford) 2003; 13: 11: 802-810.
Mehrabi A., Fonouni H., Golriz M., Hofer S., Hafezi M., Rahbari N.N., Weitz J., Büchler M.W., Schmidt J. Hypothermic ante situm resection in tumors of the hepatocaval confluence. Dig Surg 2011; 28: 2: 100-108. doi: 10.1159/000323818. Epub 2011 Apr 29.
Mekeel K.L., Hemming A.W. Combined resection of the liver and the inferior vena cava for hydatid disease. J Gastrointest Surg 2007; 11: 12: 1741-1743.
Michael Crawford, Phong Ho, James Gallagher, David Joseph, Michael Stephen, Charbel Sandroussi. et al. The use of biological grafts for reconstruction of the inferior vena cava is a safe and valid alternative: results in 32 patients in a single institution. HPB August 2013; 15: 8: 628-632.
Miyata R., Shimazu M., Kawachi S., Tanabe M., Aiura K., Wakabayashi G., Ueda M., Sakuma M., Kitajima M. Left trisegmentectomy and combined resection of the inferior vena cava, without reconstruction, for giant cystadenocarcinoma of the liver. J Hepatobiliary Pancreat Surg 2012; 12: 3: 272-276.
Neuhaus P., Jonas S., Bechstein W.O. et al. Extended resections for hilar cholangiocarcinoma. Ann Surg 1999; 230: 808-818.
Nagino M., Nimura Y., Nishio H., Ebata H., Igami T., Matsushita T., Nishikimi M., Kamei N. Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases. Ann Surg 2010; 252: 1: 115-123.
Okano K., Oshima M., Suzuki Y. Hepatic venous outflow reconstruction using an external iliac vein graft for hepatic malignancies (with video). J Hepatobiliary Pancreat Sci 1991; 19: 1: 85-90.
Post I.C., de Boon W.M., Heger M., van Wijk A.C., Kroon J., van Buul J.D., van Gulik T.M. Endothelial cell preservation at hypothermic to normothermic conditions using clinical and experimental organ preservation solutions. Exp Cell Res 2013; 319: 17: 2501-2513.
Yip S.S., Jones V., Lacasia R.P., Fenwick C., Poston S.W., Malik G.J., Liver H. resection with concomitant inferior vena cava resection: experiences without veno-venous bypass. Surg Today 2013; Epub ahead of print
Urata K., Hashikura Y., Ikegami T., Terada M., Kawasaki S. Standard liver volume in adults. Transplant Proc 2000; 32: 2093-2094.
Dong W.H., Zhang J.H., Zhao J.H., Shao J.M., Duan Y.M., Liang W.D., Ji Y.R., Tai X.W., Aji Q.W., Li T.T. Ex vivo liver resection followed by autotransplantation for end-stage hepatic alveolar echinococcosis. Chin Med J (Engl) 2011; 124: 18: 2813-2817.
Wengerter K., Dardik H. Biological vascular grafts. Semin Vasc Surg 1999; 12: 1: 46-51.
Zhang K., Hu M.X., Dong W.J., Hong H.Z., Wang X.Z., Li H.G., Qi H.R., Duan Z.W., Zhang D.S.G. Ex-situ liver surgery without veno-venous bypass. World J Gastroenterol 2008; 18: 48: 7290-7295.
Yamamoto Y. Ante-situm hepatic resection for tumors involving the confluence of hepatic veins and IVC. J Hepatobiliary Pancreat Sci 2013; 20: 3: 313-323.

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