In situ graft-trimming method using polyester vascular prosthesis for inferior vena cava reconstruction after hepatectomy.
Hepatectomy for secondary liver cancer that has invaded the inferior vena cava (IVC) can be the only way to achieve long-term survival. We describe a method for hepatectomy combined with partial IVC resection without venous bypass circulation and an in situ graft-trimming method to avoid graft size mismatch after reconstruction. We carried out left hepatectomy extended to segment 1 with partial IVC resection first. During resection and reconstruction of the IVC, it was clamped below the right hepatic vein and above the inferior right hepatic vein to maintain systemic circulation. The graft was trimmed in situ, after a half running suture of the graft was finished to ensure the correct size. Preservation of both inferior right hepatic vein and right hepatic vein helps to maintain systemic circulation during reconstruction of the IVC. The in situ graft-trimming method is an easy and safe method to ensure the correct graft size after IVC reconstruction.
Mizuguchi
Toru
T
Department of Surgery I, Sapporo Medical University Hospital, Sapporo Medical University School of Medicine, Sapporo, Japan. tmizu@sapmed.ac.jp
Katsuramaki
Tadashi
T
Morishita
Kiyofumi
K
Kawamoto
Masaki
M
Nobuoka
Takayuki
T
Imamura
Masato
M
Kimura
Yasutoshi
Y
Hirata
Koichi
K
D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011091:Polyesters; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
D011091:Polyesters