A case report on the successful perioperative management of hepatectomy for hepatocellular carcinoma in a patient with von Willebrand disease

Sato, Koki; Kuroda, Satoshi; Kobayashi, Tsuyoshi; Shimizu, Seiichi; Ohira, Masaichi; Tahara, Hiroyuki; Ide, Kentaro; Fujii, Teruhisa; Ohdan, Hideki

doi:10.1016/j.ijscr.2018.02.033

Cited by 2 publications

(5 citation statements)

References 14 publications

(17 reference statements)

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“…Therefore, the extremely low platelet count in the present case was considered to have been caused by type 2B VWD, which often coexists with thrombocytopenia [ 4 ]. Since the protocol of VWF/factor VIII administration in the present case was similar to that in previous reports [ 7 , 12 , 13 ], the extremely low preoperative platelet counts in the present patient might have caused the severe bleeding tendency.…”

Section: Discussionsupporting

confidence: 80%

“…Since the protocol of VWF/factor VIII administration in the present case was similar to that in previous reports [ 7 , 12 , 13 ], the extremely low preoperative platelet counts in the present patient might have caused the severe bleeding tendency.…”

Section: Discussionsupporting

confidence: 80%

“…Yoshimoto-Haramura et al reported that the postoperative complication rate did not increase in patients with ICD who underwent hepato-biliary-pancreatic surgery at qualified centers [ 9 ]. When limited to patients with VWD, several reports have described hepatectomies for patient safety [ 7 , 12 , 13 ]. Sato et al reported a successful open hepatectomy in a patient with type 1 VWD patient [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…When limited to patients with VWD, several reports have described hepatectomies for patient safety [ 7 , 12 , 13 ]. Sato et al reported a successful open hepatectomy in a patient with type 1 VWD patient [ 12 ]. However, their patient showed a preserved platelet count.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic liver resection for a patient of hepatocellular carcinoma with von Willebrand disease: a case report

Şal,

Sakamoto,

Tamura

et al. 2024

surg case rep

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Background The safety of laparoscopic hepatectomy for inherited coagulation disorders is unclear; however, the safety of open hepatectomy has been reported in several studies. Herein, we report the first case of a laparoscopic hepatectomy for a patient with von Willebrand Disease (VWD). Case presentation A 76-year-old male with a history of chronic hepatitis C and VWD type 2B was advised surgical resection of a 4 cm hepatocellular carcinoma in segment 7 of the liver. The patient was diagnosed with VWD in his 40 s due to gastrointestinal bleeding caused by gastric erosion. The von Willebrand factor (VWF) ristocetin cofactor activity was 30%, and VWF large multimer deficiency and increased ristocetin-induced platelet agglutination were observed. The preoperative platelet count was reduced to 3.5 × 104/μL; however, preoperative imaging findings had no evidence of liver cirrhosis, such as any collateral formations and splenomegaly. The indocyanine green retention rate at 15 min was 10%, and his Child–Pugh score was 5 (classification A). Perioperatively, VWF/factor VIII was administered in accordance with our institutional protocol. A laparoscopic partial hepatectomy of the right posterior segment was performed. The most bleeding during surgery occurred during the mobilization of the right lobe of the liver due to inflammatory adhesion between the retroperitoneum and the tumor. Bleeding during parenchymal transection was controlable. The duration of hepatic inflow occlusion was 65 min. The surgical duration was 349 min, and the estimated blood loss was 2150 ml. Four units of red blood cells and fresh frozen plasma were transfused at the initiation of parenchymal transection, and 10 units of platelets were transfused at the end of the parenchymal transection. On postoperative day 1, the transection surface drainage fluid became hemorrhagic, and emergency contrast-enhanced computed tomography showed extravasation in the greater omentum. Percutaneous transcatheter arterial embolization of the omental branch of the right gastroepiploic artery was performed. No further postoperative interventions were required. The patient was discharged on postoperative day 14. Conclusion The indications for laparoscopic hepatectomy in patients with VWD should be carefully considered, and an open approach may still be the standard approach for patients with VWD.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic liver resection for a patient of hepatocellular carcinoma with von Willebrand disease: a case report

Şal,

Sakamoto,

Tamura

et al. 2024

surg case rep

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“…15 Other case reports and studies have reported reassuring outcomes using an organized approach to determine and administer prophylactic therapies for patients with vWD undergoing surgery. 16–19 Thus, we recommend the following when preparing for endoscopy for a patient with vWD. First, evaluate the subtype of vWD.…”

Section: Discussionmentioning

confidence: 99%

Rare Co-occurrence of Eosinophilic Esophagitis and Type 2B von Willebrand Disease: Implications for Endoscopic Surveillance and Esophageal Dilation

Corder¹,

Weston

Dellon³

2019

ACG Case Rep J

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Eosinophilic esophagitis (EoE) and type 2B von Willebrand disease (vWD) are both rare diseases, and the co-occurrence is unlikely. Patients with EoE often need recurrent endoscopic dilations and esophageal biopsies, and the safety of these procedures in the setting of bleeding disorders is not well described in the literature. We describe successful management strategies in a patient with co-existing EoE and type 2B vWD who required multiple dilations and biopsies. This approach might be used for patients with other esophageal disorders and type 2B vWD as well.

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A case report on the successful perioperative management of hepatectomy for hepatocellular carcinoma in a patient with von Willebrand disease

Cited by 2 publications

References 14 publications

Laparoscopic liver resection for a patient of hepatocellular carcinoma with von Willebrand disease: a case report

Laparoscopic liver resection for a patient of hepatocellular carcinoma with von Willebrand disease: a case report

Rare Co-occurrence of Eosinophilic Esophagitis and Type 2B von Willebrand Disease: Implications for Endoscopic Surveillance and Esophageal Dilation

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