Middle hepatic vein reconstruction using a peritoneal patch: report of a case.
A 67-year-old male complaining of constipation with a change in stool caliber for several months visited our hospital in June 1999. A positive test for occult blood in the feces led to the disclosure of a type II carcinoma of the sigmoid colon with multiple liver metastases. A lymph node dissection with a sigmoidectomy disclosed no metastases histologically, so a left hepatectomy and enucleations of the metastases were performed. In addition, the invaded middle hepatic vein (MHV) was resected and repaired using a peritoneal patch. The patient's postoperative course was uneventful until July 2000, when computed tomography of the liver showed a single nodule measuring 3 cm in diameter in segment 6. The metastasis was excised in August. Since then, the patient has shown normal tumor marker values. The MHV has remained patent for 24 months after its reconstruction. A resection of the liver metastases including venous reconstruction is beneficial for patients since it results in a longer survival and allows for venous drainage of the residual liver. The peritoneum is also accessible, enabling the fitting of a patch graft for hepatic vein repair.
Akimaru
Koho
K
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
Onda
Masahiko
M
Tajiri
Takashi
T
Yoshida
Hiroshi
H
Yokomuro
Shigeki
S
Mamada
Yasuhiro
Y
Taniai
Nobuhiko
N
Yoshioka
Masato
M
Mineta
Sho
S
D000368:Aged; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D010537:Peritoneum / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods; D012811:Sigmoid Neoplasms / Q000473:pathology