Hepatic vein reconstruction for preserving remnant liver function
S. Nakamura, S. Sakaguchi, T. Kitazawa, S. Suzuki, K. Koyano and H. Muro
Second Department of Surgery, Hamamatsu University School of Medicine, Japan.
Hepatic malignancies often infiltrate to the major hepatic vein. Recently,
we performed hepatic resection combined with hepatic vein reconstruction
for preserving remnant liver function in three such patients. One patient
had a saphenous vein graft. Postoperative liver function of the patients
who underwent hepatic vein reconstruction was compared with those of eight
patients who underwent hepatic resection of segments VII and VIII. The
right hepatic vein in four of them was resected and in the remaining four
was preserved by skeletalization using an ultrasonic aspirator. Although
four patients with right hepatic vein resection showed severe lowering of
liver function after surgery, the postoperative course of patients with
preservation or reconstruction of the right hepatic vein maintained good
liver function. Liver regeneration of three patients with hepatic vein
reconstruction was good on computed tomography. Besides this report, to our
knowledge, there is no other report of hepatic vein reconstruction for
preserving the remnant liver function. Problems with hepatic resection
combined with hepatic vein reconstruction are discussed. We conclude that
hepatic vein reconstruction is one of the means for extending indication of
the malignant tumor resection of the liver.
