Usefulness of artificial vascular graft for venous reconstruction in liver surgery.
BACKGROUND
The purpose of this study was to evaluate the results of hepatectomy with inferior vena cava or hepatic vein resection, followed by vessel reconstruction with an artificial vascular graft.


METHODS
From 2000 to 2011, 1,434 patients underwent several types of hepatectomy at our institution. Of these, we reviewed the cases of eight patients (0.56%) who underwent hepatectomy with inferior vena cava or hepatic vein resection and subsequent reconstruction using an expanded polytetrafluoroethylene (PTFE) graft.


RESULTS
We resected the inferior vena cava in six patients and the hepatic vein in two patients. All eight patients underwent subsequent reconstruction using an expanded PTFE graft. The median operative time was 443 minutes and the median blood loss was 2,017 mL. The median postoperative hospital stay period was 18.5 days and the in-hospital mortality rate was 0%. Complications occurred in four patients: two patients experienced bile leakage, one experienced a wound infection, and one experienced pleural effusion. The two patients who experienced bile leakage had undergone reoperation on postoperative day 1. No complication with the artificial vascular graft occurred in these eight cases. Histological invasion to the replaced inferior vena cava or hepatic vein was confirmed in four cases. All artificial vascular grafts remained patent during the observation period.


CONCLUSIONS
Hepatectomy combined with inferior vena cava or hepatic vein resection, followed by reconstruction with an expanded PTFE graft can be performed safely in selected patients.
Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15-West 7, Kita-Ku, 060-8638 Sapporo, Hokkaido, Japan. kaorioritatsu@ybb.ne.jp.
Tatsuya
T
Orimo
Toshiya
T
Kamiyama
Hideki
H
Yokoo
Tatsuhiko
T
Kakisaka
Kenji
K
Wakayama
Yosuke
Y
Tsuruga
Hirofumi
H
Kamachi
Akinobu
A
Taketomi
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000706:statistics & numerical data*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006503:Hepatic Veins / Q000473:pathology / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D019651:Plastic Surgery Procedures; D012086:Reoperation; D015996:Survival Rate; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery