Resection of retrohepatic inferior vena cava without reconstruction in ex vivo liver resection and autotransplantation: a retrospective study

Xianwei Yang,Bin Huang,Tao Wang,Junjie Kong

doi:10.1186/s12893-020-00720-z

Xianwei Yang, Bin Huang + Show 2 more

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https://doi.org/10.1186/s12893-020-00720-z

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Abstract

BackgroundRetrohepatic inferior vena cava (RIVC) resection without reconstruction in ex vivo liver resection and autotransplantation (ERAT) for advanced alveolar echinococcosis (HAE) is unclear.MethodsThis is a retrospective study of consecutive patients referred to our hospital from 2014 to 2018. Depending on the presence of a rich collateral circulation and stable blood volume in ERAT, patients did not rebuild the RIVC. Then, patients were selected some appropriate revascularization techniques for the hepatic and renal veins. Finally, all ERAT procedures were completed, and short- and long-term outcomes were observed.ResultsFive advanced HAE patients underwent ERAT without RIVC reconstruction. One patient died of circulatory failure 1 day after surgery. Another four patients, with a median follow-up duration of 18 months (range, 10–25 months), demonstrated normal liver and kidney function, no thrombosis and no HAE recurrence.ConclusionsThrough the long-term results of ERAT, the pros and cons of not reconstructing the RIVC need to be re-examined. In cases with a rich collateral circulation, the RIVC cannot be reconstructed. However, in cases requiring the resection of multiple organs, RIVC without reconstruction was prudential.

Highlights

Retrohepatic inferior vena cava (RIVC) resection without reconstruction in ex vivo liver resection and autotransplantation (ERAT) for advanced alveolar echinococcosis (HAE) is unclear
The chief complaint was upper abdominal pain, which was observed in 2 patients
Postoperative pathology was confirmed as hepatic alveolar echinococcosis (HAE), and retrohepatic inferior vena cava (RIVC) was violated in the whole layer (Fig. 1d, e)

Summary

Introduction

Retrohepatic inferior vena cava (RIVC) resection without reconstruction in ex vivo liver resection and autotransplantation (ERAT) for advanced alveolar echinococcosis (HAE) is unclear. Intraabdominal inferior vena cava (IVC) resection is a very challenging task. When the IVC is invaded by primary or secondary lesions of the liver, the hepatic tumors and the retrohepatic inferior vena cava (RIVC) should be treated simultaneously [1, 2]. Protecting blood flow in the portal system, kidneys and lower limbs is challenging. Ex vivo liver resection and autotransplantation (ERAT) has become a hot topic in recent years [3], especially in the study of benign liver. Yang et al BMC Surgery (2020) 20:56 without reconstruction in ERAT in a 2-year follow-up study at our center

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