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Right hepatic lobectomy and removal of inferior vena caval tumor embolus in a patient with hepatocellular carcinoma, using veno‐venous bypass while preserving perfusion in the remnant liver: A case report
Author(s) -
Fujii Shoichi,
Shimada Hiroshi,
Nakano Akira,
Ohki Shigeo,
Togou Shinji,
Sekido Hitoshi,
Fukazawa Shingo,
Masui Hidenobu,
Yoda Kouhei
Publication year - 1995
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02348744
Subject(s) - medicine , inferior vena cava , embolus , hepatocellular carcinoma , hepatectomy , radiology , vein , surgery , resection
We describe a successful hepatectomy and the removal of a tumor embolus in a 43‐year‐old woman with hepatocellular carcinoma occupying the right lobe extending to the right branch of the portal vein and the inferior vena cava (IVC). Intraoperative echography revealed the tumor embolus in the IVC to originate from the main tumor via the right inferior hepatic vein, which extended cephalad from the confluence of the right hepatic vein to the IVC. Right hepatc lobectomy was performed via the anterior approach. Using femoro‐axillary veno‐venous bypass, we opened the IVC at the root of the inferior right hepatic vein to remove the tumor embolus after oblique clamping of the IVC between the right and middle hepatic veins was carried out to preserve perfusion in the remnant liver. Preserving perfusion in the remmant liver in radical hepatectomy for hepatocellular carcinoma with tumor embolism in the IVC appears to be a safe and advantageous technique in patients with poor liver reserve.