Combined hepatic and vena caval resection with autogenous caval graft replacement
C. M. Miller, M. E. Schwartz and T. Nishizaki
Department of Surgery, the Mount Sinai School of Medicine, New York, NY.
Right-sided and caudate hepatic lobectomy with resection of the
retrohepatic vena cava were performed in a 34-year-old woman with recurrent
adrenal carcinoma. The vena cava was replaced with a graft constructed from
autogenous superficial femoral vein. Included herein is a review of the
literature detailing the three previously reported cases of combined
hepatic and caval resection; to our knowledge, there are no prior reports
of the use of an autogenous vein graft in this setting. With surgical and
anesthetic techniques, including total vascular exclusion of the liver and
venovenous bypass, methods that were developed in large part through
experience in liver transplantation, this type of surgery can be performed
with a high rate of success.
