| Autor: |
Deniz Balci, Menekse Ozcelik, Elvan Onur Kirimker, Arda Cetinkaya, Evren Ustuner, Mehmet Cakici, Bahadir Inan, Zekeriyya Alanoglu, Sadik Bilgic, Ahmet Ruchan Akar |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
BMC Surgery, Vol 18, Iss 1, Pp 1-5 (2018) |
| Druh dokumentu: |
article |
| ISSN: |
1471-2482 |
| DOI: |
10.1186/s12893-018-0342-2 |
| Popis: |
Abstract Background Liver resection for intrahepatic cholangiocarcinoma (ICC) with invasion of the inferior vena cava (IVC) and hepatic veins (HV) is a challenging procedure. Case presentation We report a case of a 63-year-old woman with a 6-cm, centrally located liver mass. Her biochemistry results were normal except for a Ca19–9 level of 1199 U/ml. The liver biopsy was consistent with ICC and 60% macrosteatosis. Abdominal CT scans revealed a large central mass invading the left HV, middle HV and right HV, infringing on their junction with the vena cava. An operation was planned using a 3-dimensional (3D) computer simulation model using dedicated software. We also describe a novel veno-portal-venous extracorporeal membrane oxygenation (VPV-ECMO) support with in-situ hypothermic perfusion (IHP) during this procedure. We aimed to perform an extended left hepatectomy and reconstruct 3 right HV orifices with an interposition jump graft to the IVC with total vascular exclusion (TVE) and IHP A supplemental video describing the preoperative planning, the operative procedure with the postoperative follow-up in detail is presented. After the patient was discharged, she developed a hepatic venous outflow obstruction 3 months postoperatively, which was effectively managed with hepatic venous stenting by interventional radiology. She is currently symptom free and without tumour recurrence at the 1-year follow-up. Conclusions This report demonstrates that extended left hepatectomy for IHC with IHP and VPV-ECMO is safe and feasible under the supervision of a highly experienced team. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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