title: The necessity of hepatic vein reconstruction after resection of cranial part of the liver and major hepatic veins in cirrhotic patients.
abstract: BACKGROUND
  The necessity of hepatic vein reconstruction (HVR) after resection of cranial part of the liver and major hepatic vein(s) in cirrhotic patients when residual liver is insufficient for a major hepatectomy remains unclear.
  
  
  METHODS
  Fifty-two cirrhotic patients who underwent resection of cranial part of the liver and hepatic vein(s) for liver neoplasms were divided retrospectively into 3 groups based on the volume of the congestive area of the remnant liver after hepatectomy: group A, 28 patients, the volume of the congestive area was ≤20% of the residual liver volume and underwent no HVR; group B, 7 patients, the volume of the congestive area was >20% of residual liver volume and underwent no HVR; and group C, 17 patients, in whom HVR was performed (the volume of the congestive area was >20% of residual liver volume in 16 and <20% in 1). Background characteristics and postoperative results were compared between the groups.
  
  
  RESULTS
  Although group C patients had a significantly longer operative time, their postoperative courses were similar to group A patients. Group B patients had a significantly longer postoperative hospital stay and a greater postoperative morbidity and 90-day mortality. No 90-day mortality ensued in the group A and C patients.
  
  
  CONCLUSIONS
  In selected cirrhotic patients whose remnant liver is insufficient for major hepatectomy, HVR appears to be safe and desirable after resection of the cranial part of liver and hepatic vein when the volume of congestive area of liver remnant exceeds 20% of future residual liver volume.
authors.affiliation: Department of Surgery, Taichung Veterans General Hospital, Taiwan. he@vghtc.gov.tw
authors.forename: Cheng-Chung
authors.initials: CC
authors.lastname: Wu
authors.forename: Cheng-Ming
authors.initials: CM
authors.lastname: Peng
authors.forename: Shao-Bin
authors.initials: SB
authors.lastname: Cheng
authors.forename: Dah-Cherng
authors.initials: DC
authors.lastname: Yeh
authors.forename: Wing-Yiu
authors.initials: WY
authors.lastname: Lui
authors.forename: Tse-Jia
authors.initials: TJ
authors.lastname: Liu
authors.forename: Fang-Ku
authors.initials: FK
authors.lastname: P'eng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008099:Liver / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures