Complete devascularization of hepatic lobe with nonresectable hepatoma

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Vascular Surgery

Background:

• Nonresectable liver cell carcinoma often involves portal vein obstruction.
• Surgical management aims to devascularize tumor-bearing liver segments.
• Assessing liver tolerance to reduced blood supply is crucial.

Observation:

• Three patients with nonresectable liver cell carcinoma and portal vein obstruction underwent complete liver dearterialization.
• Postoperative remittent fever occurred in all patients.
• No hepatic infarction was observed in the devascularized lobes.

Findings:

• The tumor-bearing liver lobes tolerated near-complete deprivation of hepatic arterial and portal blood.
• The treatment demonstrated satisfactory effects on tumorous lesions.
• Non-simultaneous dearterialization allows tolerance of reduced blood flow.

Implications:

• Complete dearterialization may be a viable strategy for nonresectable liver cancer.
• This approach could offer an alternative when portal vein supply is compromised.
• Further research is warranted to explore the long-term efficacy and safety of this procedure.