When inferior vena cava (IVC) resection is mandatory during liver surgery, use of a veno-venous bypass (VVB) is usually required despite its specific related adverse events. We describe a safe and alternative technique which allows both derivation of the portal and the caval blood flow by performing a lateral cavo-caval shunt using a prosthetic graft.
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http://dx.doi.org/10.21037/tgh.2018.04.03 | DOI Listing |
Transplant Proc
June 2022
Liver and Abdominal Organs Transplantation Division, Department of Gastroenterology, Clinics Hospital, University of Sao Paulo Medical School, São Paulo, Brazil; Laboratory of Medical Investigation 37, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Background: The classic piggyback technique uses the union of the 3 hepatic veins to perform the cavo-caval anastomosis. However, due to the lateral localization of the right hepatic vein, the partial clamping of the vena cava in this technique significantly reduces the venous return to the right atrium. To avoid this, we adopted in 2015 a modified piggyback technique, in which we use the common trunk of the middle and left hepatic veins and also perform a lateral incision toward the right in the anterior wall of the vena cava in order to widen the final ostium of the cavo-caval anastomosis.
View Article and Find Full Text PDFJ Vet Med Sci
October 2020
Pingry Veterinary Hospital, Via Medaglie d'Oro 5-70126, Bari, Italy.
The internal thoracic veins (ITVs) are small paired vessels located on the ventral surface of the thoracic cavity that drain the ventro-cranial abdominal wall, the ventro-lateral thoracic wall, the diaphragm and part of the mediastinum, conveying blood from these regions into the cranial vena cava. These vessels demonstrate a high level of anatomic plasticity and haemodynamic adaptability in both humans and small animals with blood flow impairment of the main abdominal and thoracic venous trunks. The ITVs may act as a natural bypass between the cranial and caudal venous system and between the portal vein and the cranial vena cava, depending on the level of the obstruction, giving rise to a wide spectrum of collateral pathways: intrathoracic cavo-caval, thoraco-abdominal cavo-caval, abdomino-thoracic cavo-caval, porto-cranial caval and lateral thoracic-azygos ITV collaterals.
View Article and Find Full Text PDFTransl Gastroenterol Hepatol
May 2018
CHU Rennes, Service de Chirurgie Hépatobiliaire et Digestive, Rennes, France.
When inferior vena cava (IVC) resection is mandatory during liver surgery, use of a veno-venous bypass (VVB) is usually required despite its specific related adverse events. We describe a safe and alternative technique which allows both derivation of the portal and the caval blood flow by performing a lateral cavo-caval shunt using a prosthetic graft.
View Article and Find Full Text PDFHepatobiliary Surg Nutr
June 2016
1 Department of Hepato-Pancreato-Biliary and Liver Transplantation, Henri Mondor Hospital, Créteil, France ; 2 INSERM U965, Paris, France ; 3 INSERM U955, Créteil, France.
Veno-venous bypass (VVB) using a patent para-umbilical vein during liver transplantation (LT) has not been reported previously. Here, we report the decompression of the porto-mesenteric compartment via a patent para-umbilical vein in a patient needing a VVB during LT. Pre-transplant CT-scan showed a large patent para-umbilical vein.
View Article and Find Full Text PDFChin Med J (Engl)
September 2011
State Key Lab Breeding Base of Xinjiang Major Disease Research and Department of Liver and Laparoscopic Surgery, First Affiliated Hospital of Xinjiang Medical University, Xinjiang Organ Transplantation Research Institute, Urumqi, Xinjiang 830054, China.
Background: For patients with end-stage hepatic alveolar echinococcosis (AE), in vivo resection of the involved parts of the liver is usually very difficult, therefore, allogenic liver transplantation is indicated. However, we hypothesize that for selected patents, ex vivo liver resection for thorough elimination of the involved tissues and liver autotransplantation may offer a chance for clinical cure.
Methods: We presented a 24-year-old women with a giant hepatic AE lesion who was treated with hepatectomy, ex vivo resection of the involved tissue and hepatic autotransplantation.
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