Resection of Retrohepatic Inferior Vena Cava Without Reconstruction in Ex Vivo Liver Resection and Autotransplantation: a Retrospective Study

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2020 Mar 27

PMID 32209078

Citations 6

Authors

Xianwei Yang

Tao Wang

Junjie Kong

Bin Huang

WenTao Wang

Affiliations

Soon will be listed here.

Abstract

Background: Retrohepatic inferior vena cava (RIVC) resection without reconstruction in ex vivo liver resection and autotransplantation (ERAT) for advanced alveolar echinococcosis (HAE) is unclear.

Methods: This is a retrospective study of consecutive patients referred to our hospital from 2014 to 2018. Depending on the presence of a rich collateral circulation and stable blood volume in ERAT, patients did not rebuild the RIVC. Then, patients were selected some appropriate revascularization techniques for the hepatic and renal veins. Finally, all ERAT procedures were completed, and short- and long-term outcomes were observed.

Results: Five advanced HAE patients underwent ERAT without RIVC reconstruction. One patient died of circulatory failure 1 day after surgery. Another four patients, with a median follow-up duration of 18 months (range, 10-25 months), demonstrated normal liver and kidney function, no thrombosis and no HAE recurrence.

Conclusions: Through the long-term results of ERAT, the pros and cons of not reconstructing the RIVC need to be re-examined. In cases with a rich collateral circulation, the RIVC cannot be reconstructed. However, in cases requiring the resection of multiple organs, RIVC without reconstruction was prudential.

Citing Articles

Intrahepatic Venous Collateral Circulation and Reverse Blood Flow After Main Hepatic Vein Obstruction: A Case Report with Literature Review.

Ning J, Aini Y, Jiang T, Shao Y, Aji T, Wen H Ann Transplant. 2023; 28:e941521.

PMID: 37933096 PMC: 10638859. DOI: 10.12659/AOT.941521.

Complex inferior vena cava reconstruction during liver resection and autotransplantation: A case report.

Humaerhan J, Jiang T, Aji T, Shao Y, Wen H World J Clin Cases. 2023; 11(23):5602-5609.

PMID: 37637699 PMC: 10450365. DOI: 10.12998/wjcc.v11.i23.5602.

Collateral circulation caused by end-stage hepatic alveolar echinococcosis.

Jiang T, Aji T, Ran B, Guo Q, Zhang R, Ahan A BMC Infect Dis. 2023; 23(1):322.

PMID: 37189056 PMC: 10184362. DOI: 10.1186/s12879-022-07970-7.

Approaches to reconstruction of inferior vena cava by liver resection and autotransplantation in 114 patients with hepatic alveolar echinococcosis.

Maimaitinijiati Y, Aji T, Jiang T, Ran B, Shao Y, Zhang R World J Gastroenterol. 2022; 28(31):4351-4362.

PMID: 36159005 PMC: 9453774. DOI: 10.3748/wjg.v28.i31.4351.

Treatment of Complicated Hepatic Alveolar Echinococcosis Disease With Suspicious Lymph Node Remote Metastasis Near the Inferior Vena Cava-Abdominal Aorta: A Case Report and Literature Review.

Xu X, Gao C, Qian X, Liu H, Wang Z, Zhou H Front Oncol. 2022; 12:849047.

PMID: 35402272 PMC: 8987535. DOI: 10.3389/fonc.2022.849047.

References

Bi Y, Chen H, Ding P, Ren J, Han X . Comparison of retrievable stents and permanent stents for Budd-Chiari syndrome due to obstructive inferior vena cava. J Gastroenterol Hepatol. 2018; 33(12):2015-2021. DOI: 10.1111/jgh.14295. View

Qiu Y, Yang X, Shen S, Huang B, Wang W . Vascular infiltration-based surgical planning in treating end-stage hepatic alveolar echinococcosis with ex vivo liver resection and autotransplantation. Surgery. 2018; 165(5):889-896. DOI: 10.1016/j.surg.2018.11.007. View

Beldi G, Vuitton D, Lachenmayer A, Heyd B, Dufour J, Richou C . Is ex vivo liver resection and autotransplantation a valid alternative treatment for end-stage hepatic alveolar echinococcosis in Europe?. J Hepatol. 2019; 70(5):1030-1031. DOI: 10.1016/j.jhep.2018.12.011. View

Du C, Liu Z, Yang X, Yan L, Li B, Wen T . Hepatectomy for patients with alveolar echinococcosis: Long-term follow-up observations of 144 cases. Int J Surg. 2016; 35:147-152. DOI: 10.1016/j.ijsu.2016.09.094. View

Shen S, Kong J, Qiu Y, Zhang S, Qin Y, Wang W . Ex vivo liver resection and autotransplantation versus allotransplantation for end-stage hepatic alveolar echinococcosis. Int J Infect Dis. 2018; 79:87-93. DOI: 10.1016/j.ijid.2018.11.016. View

Yang X, Qiu Y, Wang W, Feng X, Shen S, Li B . Risk factors and a simple model for predicting bile leakage after radical hepatectomy in patients with hepatic alveolar echinococcosis. Medicine (Baltimore). 2017; 96(46):e8774. PMC: 5704878. DOI: 10.1097/MD.0000000000008774. View

Yang X, Qiu Y, Huang B, Wang W, Shen S, Feng X . Novel techniques and preliminary results of ex vivo liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis: A study of 31 cases. Am J Transplant. 2017; 18(7):1668-1679. PMC: 6055796. DOI: 10.1111/ajt.14621. View

Shen S, Kong J, Zhao J, Wang W . Outcomes of different surgical resection techniques for end-stage hepatic alveolar echinococcosis with inferior vena cava invasion. HPB (Oxford). 2019; 21(9):1219-1229. DOI: 10.1016/j.hpb.2018.10.023. View

Aji T, Dong J, Shao Y, Zhao J, Li T, Tuxun T . Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis. J Hepatol. 2018; 69(5):1037-1046. DOI: 10.1016/j.jhep.2018.07.006. View

10.

Wen H, Vuitton L, Tuxun T, Li J, Vuitton D, Zhang W . Echinococcosis: Advances in the 21st Century. Clin Microbiol Rev. 2019; 32(2). PMC: 6431127. DOI: 10.1128/CMR.00075-18. View

11.

Kern P, Wen H, Sato N, Vuitton D, Gruener B, Shao Y . WHO classification of alveolar echinococcosis: principles and application. Parasitol Int. 2005; 55 Suppl:S283-7. DOI: 10.1016/j.parint.2005.11.041. View

12.

Wachtel H, Jackson B, Bartlett E, Karakousis G, Roses R, Bavaria J . Resection of primary leiomyosarcoma of the inferior vena cava (IVC) with reconstruction: a case series and review of the literature. J Surg Oncol. 2014; 111(3):328-33. DOI: 10.1002/jso.23798. View

13.

Yoon Y, Lee S, Moon D, Ahn C, Hwang S, Kim K . Surgical Techniques and Long-term Outcomes of Living-donor Liver Transplantation With Inferior Vena Cava Replacement Using Atriocaval Synthetic Interposition Graft for Budd-Chiari Syndrome. Ann Surg. 2018; 269(4):e43-e45. DOI: 10.1097/SLA.0000000000002847. View

14.

Botrugno I, Gruttadauria S, Li Petri S, Cintorino D, Spada M, DI Francesco F . Complex hydatid cysts of the liver: a single center's evolving approach to surgical treatment. Am Surg. 2010; 76(9):1011-5. View

15.

Jaiswal P, Jaiswal R, Attar B, Dedania B, Wang Y, Basu A . Hepatobiliary and Pancreatic: Massive hepatic cystic echinococcosis compressing inferior vena cava. J Gastroenterol Hepatol. 2018; 33(2):339. DOI: 10.1111/jgh.14038. View