Modified liver hanging maneuver during orthotopic liver transplantation with inferior vena cava preservation: results after 120 consecutive applications.
The outflow venovenous anastomosis represent a crucial aspect during orthotopic liver transplantation (OLT) with inferior vena cava (IVC) preservation. The modified Belghiti liver hanging maneuver applied to the last phase of hepatectomy, lifting the liver, provides a better exposure of the suprahepatic region and allows easier orthogonal clamping of the three suprahepatic veins with a minimal portion of IVC occlusion. The outflow anastomosis constructed with a common cloacae of the three native suprahepatic veins is associated with a lower incidence of graft related venous outflow complications. The procedure planned in 120 consecutive OLT was achieved in 118 (99%). The outflow anastomosis was constructed on the common cloaca of the three hepatic veins in 111/120 cases (92.5%). No major complications were observed (bleeding during tunnel creation, graft outflow dysfunction, etc) except in one patient with acute Budd-Chiari, who successfully underwent retransplantation.
Ettorre
G M
GM
Department of Digestive Surgery and Liver Transplantation, Regina Elena Cancer Institute, Rome, Italy. ettorre@ifo.it
Vennarecci
G
G
Santoro
R
R
Boschetto
A
A
Miglioresi
L
L
Corazza
V
V
Mancini
P
P
Lorusso
R
R
Spoletini
D
D
Antonini
M
M
Tacconi
G
G
Santoro
E
E
D006502:Budd-Chiari Syndrome / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D009926:Organ Preservation; D012086:Reoperation; D012189:Retrospective Studies; D014682:Vena Cava, Inferior