Hepatobiliary Resection with Inferior Vena Cava Resection and Reconstruction Using an Autologous Patch Graft for Intrahepatic Cholangiocarcinoma

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2007 Nov 29

PMID 18043938

Citations 6

Authors

Tsuyoshi Sano

Kazuaki Shimada

Satoshi Nara

Minoru Esaki

Yoshihiro Sakamoto

Tomoo Kosuge

Affiliations

Soon will be listed here.

Abstract

Background: In patients with advanced cholangiocarcinoma involving the inferior vena cava (IVC), an extended hepatobiliary resection with combined resection and reconstruction of the IVC is often prerequisite to obtain a clear resection margin.

Materials And Methods: We present our approach to repair of approximately half of a cross-sectional wall defect of the IVC using an autologous external iliac venous patch graft during extended hepatobiliary resection with a total hepatic vascular exclusion technique. The harvested external iliac vein graft was incised longitudinally and trimmed to fit the IVC defect. After multiple stay sutures, a continuous running suture using 4-0 prolene was made.

Results: Two patients who underwent this complex surgery survive 20 and 27 months after surgery, respectively. Morbidity of transient edema of the ipsilateral lower leg potentially related to graft harvesting was noted in one patient after surgery.

Conclusions: The external iliac vein patch graft for IVC resection and reconstruction during hepatobiliary resection is technically simple, produces no stenosis or caliber change in the reconstructed IVC, and is applicable for at least half or less of a cross-sectional defect of the IVC wall to be reconstructed.

Citing Articles

Vascular Involvements in Cholangiocarcinoma: Tips and Tricks.

Angelico R, Sensi B, Parente A, Siragusa L, Gazia C, Tisone G Cancers (Basel). 2021; 13(15).

PMID: 34359635 PMC: 8345051. DOI: 10.3390/cancers13153735.

Assessing resectability in cholangiocarcinoma.

Sano T, Shimizu Y, Senda Y, Kinoshita T, Nimura Y Hepat Oncol. 2018; 1(1):39-51.

PMID: 30190940 PMC: 6114008. DOI: 10.2217/hep.13.6.

Pancreatoduodenectomy combined with portal-superior mesenteric vein resection and reconstruction with interposition grafts for cancer: a meta-analysis.

Song W, Yang Q, Chen L, Sun Q, Zhou D, Ye S Oncotarget. 2017; 8(46):81520-81528.

PMID: 29113411 PMC: 5655306. DOI: 10.18632/oncotarget.20866.

Indication for the use of an interposed graft during portal vein and/or superior mesenteric vein reconstruction in pancreatic resection based on perioperative outcomes.

Hirono S, Kawai M, Tani M, Okada K, Miyazawa M, Shimizu A Langenbecks Arch Surg. 2014; 399(4):461-71.

PMID: 24663295 DOI: 10.1007/s00423-014-1182-x.

Hepatobiliary resection with concomitant resection of the inferior vena cava for advanced intrahepatic cholangiocarcinoma: report of a case.

Nakagawa A, Igami T, Sugawara G, Ebata T, Yokoyama Y, Takahashi Y Surg Today. 2012; 43(11):1321-5.

PMID: 22961194 DOI: 10.1007/s00595-012-0319-1.

References

Nagino M, Nishio H, Ebata T, Yokoyama Y, Igami T, Nimura Y . Intrahepatic cholangiojejunostomy following hepatobiliary resection. Br J Surg. 2006; 94(1):70-7. DOI: 10.1002/bjs.5531. View

Liu C, Fan S, Lo C, Wong Y, Ng I, Lam C . Abdominal drainage after hepatic resection is contraindicated in patients with chronic liver diseases. Ann Surg. 2004; 239(2):194-201. PMC: 1356212. DOI: 10.1097/01.sla.0000109153.71725.8c. View

Sano T, Shimada K, Sakamoto Y, Yamamoto J, Yamasaki S, Kosuge T . One hundred two consecutive hepatobiliary resections for perihilar cholangiocarcinoma with zero mortality. Ann Surg. 2006; 244(2):240-7. PMC: 1602147. DOI: 10.1097/01.sla.0000217605.66519.38. View

Moriura S, Nimura Y, Hayakawa N, Maeda S, Kamiya J, Kondo S . Combined resection of the inferior vena cava for hepato-biliary and pancreatic malignancies. Hepatogastroenterology. 1990; 37(2):253-5. View

Miyazaki M, Ito H, Nakagawa K, Ambiru S, Shimizu H, Okuno A . Aggressive surgical resection for hepatic metastases involving the inferior vena cava. Am J Surg. 1999; 177(4):294-8. DOI: 10.1016/s0002-9610(99)00044-6. View

Yamamoto H, Hayakawa N, Ogawa A, Sakamoto E, Nagino M, Kamiya J . Segmental resection and reconstruction of the inferior vena cava with an autogenous vein graft. Br J Surg. 1997; 84(1):51. View

Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y . Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann Surg. 2006; 243(3):364-72. PMC: 1448943. DOI: 10.1097/01.sla.0000201482.11876.14. View

Burt B, Brown K, Jarnagin W, DeMatteo R, Blumgart L, Fong Y . An audit of results of a no-drainage practice policy after hepatectomy. Am J Surg. 2002; 184(5):441-5. DOI: 10.1016/s0002-9610(02)00998-4. View

Emre S, Schwartz M, Katz E, Miller C . Liver resection under total vascular isolation. Variations on a theme. Ann Surg. 1993; 217(1):15-9. PMC: 1242728. DOI: 10.1097/00000658-199301000-00004. View

10.

Antolovic D, Koch M, Galindo L, Wolff S, Music E, Kienle P . Hepaticojejunostomy--analysis of risk factors for postoperative bile leaks and surgical complications. J Gastrointest Surg. 2007; 11(5):555-61. DOI: 10.1007/s11605-007-0166-3. View

11.

Sarkar R, Eilber F, Gelabert H, Quinones-Baldrich W . Prosthetic replacement of the inferior vena cava for malignancy. J Vasc Surg. 1998; 28(1):75-81; discussion 82-3. DOI: 10.1016/s0741-5214(98)70202-2. View

12.

Bismuth H, Castaing D, Garden O . Major hepatic resection under total vascular exclusion. Ann Surg. 1989; 210(1):13-9. PMC: 1357759. DOI: 10.1097/00000658-198907000-00002. View

13.

Okada Y, Nagino M, Kamiya J, Yamamoto H, Hayakawa N, Nimura Y . Diagnosis and treatment of inferior vena caval invasion by hepatic cancer. World J Surg. 2003; 27(6):689-94. DOI: 10.1007/s00268-003-6908-9. View

14.

Nagino M, Kamiya J, Kanai M, Uesaka K, Sano T, Yamamoto H . Right trisegment portal vein embolization for biliary tract carcinoma: technique and clinical utility. Surgery. 2000; 127(2):155-60. DOI: 10.1067/msy.2000.101273. View

15.

Kumada K, Shimahara Y, Fukui K, Itoh K, Morikawa S, Ozawa K . Extended right hepatic lobectomy: combined resection of inferior vena cava and its reconstruction by EPTFE graft (Gore-Tex). Case report. Acta Chir Scand. 1988; 154(7-8):481-3. View

16.

Miyazaki M, Itoh H, Kaiho T, Ambiru S, Togawa A, Sasada K . Portal vein reconstruction at the hepatic hilus using a left renal vein graft. J Am Coll Surg. 1995; 180(4):497-8. View

17.

Yamaoka Y, Ozawa K, Kumada K, Shimahara Y, Tanaka K, Mori K . Total vascular exclusion for hepatic resection in cirrhotic patients. Application of venovenous bypass. Arch Surg. 1992; 127(3):276-80. DOI: 10.1001/archsurg.1992.01420030038007. View

18.

Huguet C, Nordlinger B, Galopin J, Bloch P, Gallot D . Normothermic hepatic vascular exclusion for extensive hepatectomy. Surg Gynecol Obstet. 1978; 147(5):689-93. View

19.

Sarmiento J, Bower T, Cherry K, Farnell M, Nagorney D . Is combined partial hepatectomy with segmental resection of inferior vena cava justified for malignancy?. Arch Surg. 2003; 138(6):624-30; discussion 630-1. DOI: 10.1001/archsurg.138.6.624. View

20.

Lodge J, Ammori B, Prasad K, Bellamy M . Ex vivo and in situ resection of inferior vena cava with hepatectomy for colorectal metastases. Ann Surg. 2000; 231(4):471-9. PMC: 1421021. DOI: 10.1097/00000658-200004000-00004. View