Ex-vivo liver resection combined partial liver autotransplantation for hepatocellular carcinoma located at critical site.

Abstract

：Ex-vivo liver resectionis developed based on liver transplantation and technique of cold preservation oforgans.It overcomes the shortcomings of time limit of warm ischemia and high techniquedemand of hepatectomy of tumors located at critical sites.A 58-year-old woman withhepatocellular carcinoma located close to the middle hepatic vein combined with invasionof right hepatic vein was admitted to Southwest Hospital.Because of the critical tumorsite,conventional liver resection Wag assessed as impossible.Ex-vivo liver resection wasperformed,and a vessel patch from an organ wag harvested to repair the defect of the righthepatic vein,and then the liver remnant was subsequently autotransplanted.Afteroperation,the patient recovered smoothly without venous outflow complication.Bile leakagewag observed on postoperative day 23,and the maximnm volume of intraperitoneal drainagewag 200 ml per 24 hours.Endoscopic nasobiliary drainage Was performed and the volume ofintraperitoneal drainage gradually decreased to none.Liver function of the patient wasback to normal and with no tumor recurrence at the end of 6 months of followup.Ex-vivoliver resection is beneficial to patients with centrally located hepatocellularcarcinoma with the involvement of hepatic vein and inferior vena cava. Key words: Ex-vivo liver resection; Liver transplanration,autologous; Liverneoplasms