Resección hepática extendida con vena cava inferior por colangiocarcinoma intrahepático: presentación de 2 casos / Extended hepatic resection with inferior cava vein for intrahepatic cholangiocarcinoma: presentation of two cases

Resumen Introducción: El colangiocarcinoma intrahepático (CIH) corresponde al segundo tumor hepático primario y la resección quirúrgica es la única alternativa válida para el tratamiento curativo de esta enfermedad. Reporte de casos: Describimos 2 paciente portadores de CIH con compromiso de vena cava inferior (VCI) que fueron sometidos a resección en Clínica Alemana de Santiago (CAS). Ambas pacientes son de género femenino de 39 y 47 años de edad. Ambas fueron sometidas a resección mayor hepática izquierda, asociada a resección del segmento I y extendida a VCI. La reconstrucción de la VCI fue realizada con parche pericárdico bovino y cierre primario respectivamente. El período desde el posoperatorio hasta el alta, fue de 13 y 23 días respectivamente. Discusión: Aunque la reseccion quirúrgica es la única vía para la curación en el CIH, el compromiso de estructuras vasculares hacen que esto no sea posible. El manejo multidisciplinario asociado a una técnica meticulosa realizada por un equipo quirúrgico experimentado, hacen posible lograr buenos resultados.

Introduction: Intrahepatic cholangiocarcinoma is the second most common primary liver tumor and surgical resection the only valid curative treatment. Case reports: We describe two patients harboring an intrahepatic cholangiocarcinoma with cava vein involvement who underwent resection at Clinica Alemana of Santiago. Both patients were females with ages of 39 and 47 years old. Both patients underwent left liver resection, associated to resection of segment I and of a portion of cava vein. Reconstruction of resected portion of the cava vein was performed by using a pericardium bovine patch and primary closure respectively. Postoperative period was uneventfully being discharged at 13 and 23 days respectively. Discussion: Although surgical resection is the only way to get curativeness, frequent involvement of large vascular structures make treatment unfeasible. A multidisciplinary approach associated with a meticulous technique performed by an experienced surgical team make possible to accomplish the above objective.

Image analysis of Budd-Chiari syndrome in Henan province of China / 中华放射学杂志

Objective To investigate the distribution of the obstructive lesion of hepatic vein and inferior cava vein in patients with Budd-Chiari syndrome in Henan Province of China.Methods A total of 231 cases with Budd-Chiari syndrome were diagnosed by combination of three imaging techniques which either included colour Dopple ultrasound,multislice CT and vasography or colour Dopple ultrasound,MR angiography and vasography.All the hepatic veins,accessory hepatic veins and inferior vena cavae were imaged and their obstructions were detected and analysed.Results Out of the 231 patients there were 5 cases(2.2%)with simple obstruction of inferior vena cava with normal hepatic branches.Thirty-three cases(14.3%)had simple hepatic vein obstruction with normal inferior vena cava.The remaining 193(83.5%)cases had vein obstruction both in hepatic vein and inferior vena cava.Conclusion The most frequent form of Budd-Chiari symdrome in Henan province of China is the complex obstruction of inferior vena cava and heptic vein,and simple obstruction of inferior vena cava occurs the least.