Anatomical hepatectomy combined with inferior vena cava reconstruction for the treatment of hepatic cancer / 中国普通外科杂志

ABSTRACT

Objective To evaluate concomitant anatomical hepatectomy and inferior vena cava (IVC) reconstruction for hepatic cancer. Methods Between Aug 2004 and Jul 2005, three patients with intrahepatic cholangiocarcinoma and two patients with hepatocellular carcinoma suspected to invade the wall of IVC underwent concomitant hepatectomy, IVC resection and reconstruction under portal triad clamping (PTC), total vascular exclusion(HVE) without venovenous bypass. The retrohepatic IVC was repaired by primary suture (n = 2), a Gore-Tex patch (n = 1), and a ringed ePTFE graft ( n = 1). Results Surgery was successful in all cases without operative death. The mean operative time was 345 min (range 300 ~ 450 min) ,and the mean intraoperative blood loss was 1375 ml (range 1200 ~ 1800 ml). The cumulated mean PTC and HVE times were 19 min and 21.2 min respectively. Postoperative complications included pleural effusion in one needing thoracentesis, bile leakage and ascites in one each. During the follow-up, one patient died at 9 months due to recurrence, and the remaining 4 patients were alive at the follow-up of 4 to 15 months. Conclusions Concomitant hepatectomy with IVC resection offers hope for patients with hepatic tumors involving the IVC, who would otherwise have a dismal prognosis.