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In situ hepatic vein graft: a simple new technique for hepatic venous reconstruction
Junichi Shindoh1, Norihiro Kokudo, Yasuro Miura
1Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Background/Aims:
In extended left hepatectomy including venous resection of proximal portion of the MHV, a simple new venous reconstruction technique was attempted to bypass the long gap between the stump of peripheral portion of MHV and IVC.
Methodology:
One of the hepatic venous branches in resecting side of the liver was dissected during liver transection. The dissected vein was left attached to the IVC at its proximal portion and the distal end was directly anastomosed with the stump of MHV as an alternative venous drainage rout.
Results:
Of 282 hepatectomies performed for metastatic liver tumor in Tokyo University Hospital from 1995 to 2004, two patients were treated with the present technique. With the in situ hepatic vein graft method, postoperative venous congestion was successfully avoided in both of two cases and drainage areas of the reconstructed vein showed sufficient parenchymal regeneration.
Conclusions:
In situ hepatic vein graft might be useful and possibly superior to conventional free venous graft in reconstructing long venous gap in selected patients from the viewpoint of its safety, curative potential, and the long-term patency.
