[Acute Budd-Chiari syndrome following hepatectomy. Apropos of two cases]

The authors report about 2 cases of Budd-Chiari syndrome occurring during the immediate postoperative period of extensive hepatectomy, after exeresis of a large biliary cyst (20 cm in diameter) through 6/7 sectoriectomy and after exeresis of a large sarcomatous tumor preserving only sectors 2 and 3 of the liver using an "ex-vivo/in-situ" technique. These 2 cases lead to discuss the diagnosis, treatment and, most importantly, the prevention of acute suprahepatic obstruction after extensive right hepatectomy. Similar cases are reported in the literature after partial liver transplantation. Prevention basically consists in tethering the remaining liver to prevent rotation around the vena cava or the remaining suprahepatic vein. The emptied subphrenic fossa may be filled up using the omentum or the right flexure of the colon.