[Preliminary results with "ex situ" surgery for hepatic tumors: an alternative between palliative treatment and liver transplantation?].
We report 3 cases of liver tumors which were unsuitable for conventional resection and which were removed using a technique combining hypothermic portal perfusion with an anhepatic period of more than 2 hours. The liver was mobilized after section of the infra- and supra-hepatic inferior vena cava in 2 cases. The tumor was a cholangiocarcinoma in 2 cases and colonic metastasis in 1 case. Non-tumoral liver parenchyma was normal in all cases. The inferior vena cava was involved by the tumor in 2 cases. Complete tumor resection was achieved in all cases, but required reconstruction of the hepatic veins in 1 case. Two patients in whom portal venous bypass was not used developed hemodynamic failure after liver revascularization. One of them died. In patients without underlying chronic liver disease and with unresectable tumor by conventional technique, "ex situ" resection can be a worthwhile therapeutic alternative.
Belghiti
J
J
Service de Chirurgie Digestive, Hôpital Beaujon, Université Paris VII, Clichy.
Dousset
B
B
Sauvanet
A
A
Lipinska
E
E
Aschehoug
J
J
Fékété
F
F
D002759:Adenoma, Bile Duct / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006503:Hepatic Veins / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000503:physiopathology / Q000601:surgery
Résultats préliminaires de l'exérèse "ex situ" des tumeurs hépatiques: une place entre les traitements palliatifs et la transplantation?