title: Extended hepatectomy with ePTFE graft vena caval replacement and hepatic vein reconstruction: a case report.
abstract: A 69 year-old man with a history of thoracoplastic surgery for pulmonary tuberculosis, who required a blood transfusion and subsequently tested positive for hepatitis C virus, developed a right hypochondrial mass, swelling of the lower extremities and malaise. A huge hepatocellular carcinoma invading the suprahepatic vena cava with tumor thrombi was diagnosed radiographically. An extended right hepatectomy with supra- to retrohepatic IVC resection was performed in an en bloc fashion using a centrifugal pump for hepatic vascular exclusion (HVE). The supra- to retrohepatic IVC was replaced with an expanded polytetrafluoroethylene (ePTFE) graft, 20 mm x 10 cm in size, and the left hepatic venous confluence was reconstructed. Twenty-one months after surgery, the patient is in good condition without recurrence of tumor.
authors.affiliation: Second Department of Surgery, Gunma University School of Medicine, Japan. jpsohwada@sb.gunma-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Ohwada
authors.forename: Y
authors.initials: Y
authors.lastname: Kawashima
authors.forename: T
authors.initials: T
authors.lastname: Ogawa
authors.forename: T
authors.initials: T
authors.lastname: Ohya
authors.forename: I
authors.initials: I
authors.lastname: Takeyoshi
authors.forename: A
authors.initials: A
authors.lastname: Saito
authors.forename: K
authors.initials: K
authors.lastname: Kawashima
authors.forename: Y
authors.initials: Y
authors.lastname: Morishita
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009360:Neoplastic Cells, Circulating; D011138:Polytetrafluoroethylene; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*
chemical_list: D011138:Polytetrafluoroethylene