Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Case report
Language English
Peer review Peer reviewed
Title Left hepatectomy with suprahepatic inferior vena cava resection and reconstruction under veno-arterial extracorporeal membrane oxygenation for intrahepatic cholangiocarcinoma: a case report.
Journal Formal name:Surgical case reports
Abbreviation:Surg Case Rep
ISSN code:21987793/21987793
Domestic / ForeginForegin
Volume, Issue, Page 8(1),pp.185
Author and coauthor ARIIZUMI Shunichi†, YAMAMOTO Masakazu, HAMASAKI Azumi, KOTERA Yoshihito, KATO Takaaki, EGAWA Hiroto, NIIZAMI Hiroshi, HONDAGoro
Authorship Lead author
Publication date 2022/09/28
Summary BACKGROUND:Curative surgery is the most effective treatment for intrahepatic cholangiocarcinoma (ICC). When an ICC involves the suprahepatic inferior vena cava (IVC), hepatectomy with suprahepatic IVC resection and reconstruction is challenging. For reconstruction of the suprahepatic IVC, total hepatic vascular exclusion (THVE), veno-venous bypass, and/or in situ hypothermic portal perfusion are required, but mortality and morbidity remain high.CASE PRESENTATION:We present a 73-year-old woman with mass-forming ICC which invaded the suprahepatic IVC and middle hepatic vein. Left hepatectomy, suprahepatic IVC resection, and reconstruction with an artificial graft were successfully performed during veno-arterial extracorporeal membrane oxygenation (V-A ECMO) to maintain blood pressure. While clamping the IVC diagonally, the right hepatic vein confluence could be preserved. No congestion in the right liver was seen; therefore, there was no requirement for the Pringle maneuver or THVE during reconstruction. No morbidity or mortality was seen after surgery.CONCLUSIONS:Hepatectomy with suprahepatic IVC resection and reconstruction under V-A ECMO can be performed safely. When an ICC invades the suprahepatic IVC, V-A ECMO during resection and reconstruction of the suprahepatic IVC with an artificial graft is recommended as one of the options.
DOI 10.1186/s40792-022-01468-9
PMID 36169747