Two-step selective clamping of IVC for removal of hepatocellular carcinoma with intracaval extension.
Hepatocellular carcinoma (HCC) with retrohepatic intracaval extensions are difficult to treat. HCC may sometimes extend into the inferior vena cava (IVC) through two routes: via the right hepatic vein and via the inferior right hepatic vein. In such cases, in which tumor emboli are located both above and below the confluence of the hepatic vein with the IVC, we first remove the upper embolus during THVE, and then remove the lower one while the IVC is clamped obliquely in order to preserve the residual liver circulation.
Togo
S
S
Department of Surgery II, Yokohama City University School of Medicine, Yokohama, Japan.
Shimada
H
H
Tanaka
K
K
Fujii
Y
Y
Takeda
K
K
Endo
I
I
Sekido
H
H
Kamimukai
N
N
Nagahori
K
K
D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D003250:Constriction; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D009360:Neoplastic Cells, Circulating; D011183:Postoperative Complications; D014682:Vena Cava, Inferior / Q000473:pathology* / Q000601:surgery