Modified ante situm liver resection without use of cold perfusion nor veno-venous bypass for treatment of hepatic lesions infiltrating the hepatocaval confluence

Oldhafer, Felix; Ringe, Kristina; Timrott, Kai; Kleine, Moritz; Beetz, Oliver; Ramackers, Wolf; Cammann, Sebastian; Klempnauer, Jürgen; Vondran, Florian W. R.; Bektaş, H.

doi:10.1007/s00423-018-1658-1

Cited by 25 publications

(21 citation statements)

References 21 publications

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“…Preoperative evaluation of patients who are candidates for this surgical technique is important, as this technique should only be considered for patients who have a normal liver function with non-resectable tumors [4].…”

Section: Discussionmentioning

confidence: 99%

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Ex vivo resection and temporary portocaval shunt of unresectable hepatocellular carcinoma followed by autotransplantation of liver: a case report

et al. 2020

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Background: Ex situ liver resection and autotransplantation is among the most advanced techniques which has been introduced in recent years. Case presentation: A 24-year-old male referred with chief complaints of abdominal pain, nausea, and vomiting from 1 month prior to admission. Computed tomography showed a large liver mass in the left lobe of the liver with involvement of retrohepatic inferior vena cava (IVC), in favor of hepatocellular carcinoma. After hepatectomy, the common bile duct was completely removed. A 4-cm Dacron graft was anastomosed to the inferior and top of the IVC. A temporary portocaval shunt was placed, and ex situ resection of the left lobe of the liver was done. Remnant of the liver was implanted. Reconstruction of the bile duct was done using a Roux-en-Y technique, and autotransplantation of the liver was then completed. During a 4-year follow-up, the patient had no complaints and is in good conditions. Conclusion: With appropriate consideration of patients, despite surgical complexities, ex situ resection of unresectable HCC can provide excellent prognosis.

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Section: Discussionmentioning

confidence: 99%

“…In this technique, first, the liver is resected, after which ex situ surgery is performed on the part of the liver which includes the tumor. Finally the part of the liver segments which do not include the tumor are re-transplanted [3,4].…”

Section: Introductionmentioning

confidence: 99%

Ex vivo resection and temporary portocaval shunt of unresectable hepatocellular carcinoma followed by autotransplantation of liver: a case report

et al. 2020

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“…One article was omitted due to duplicate data [33]. This resulted in 14 articles included in the final qualitative synthesis [14,[34][35][36][37][38][39][40][41][42][43][44][45][46]. All 14 articles were case series and thus uncontrolled-observational trials.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Unfortunately, these procedures are limited by hepatic intolerance to warm ischemia, hemodynamic instability, and intestinal vasculature congestion [49]. In an attempt to ameliorate these complications, venovenous bypass and hypothermic hepatic perfusion are commonlyusedstrategies [31,43,50]. Of the surveyed reports in this review, 20% of cases utilized an ex vivo approach; whereas only 3% performed an ante situm resection and 10% an in situ approach.…”

Section: Study Population and Surgical Characteristicsmentioning

confidence: 99%

Current trends in vena cava reconstructive techniques with major liver resection: a systematic review

Baimas-George

Tschuor

Watson

et al. 2020

Langenbecks Arch Surg

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Purpose: Historically, invasion of the inferior vena cava (IVC) represented advanced and often unresectable hepatic disease. With surgical and anesthetic innovations, IVC resection and reconstruction have become feasible in selected patients. This review assesses technical variations in reconstructive techniques and post-operative management. Methods: A comprehensive literature search was performed according to PRISMA. Inclusion criteria were (i) peer-reviewed articles in English; (ii) at least three cases; (iii) hepatic IVC resection and reconstruction (January 2015-March 2020). Primary outcomes were reconstructive technique, anti-thrombotic regimen, post-operative IVC patency, and infection. Secondary outcomes included post-operative complications and malignant disease survival. Results: Fourteen articles were included allowing for investigation of 351 individual patients. Analysis demonstrated significant heterogeneity in surgical reconstructive technique, anti-thrombotic management, and postoperative monitoring of patency. There was increased utilization of ex vivo approaches and decreased use of venovenous bypass compared with previously published reviews. Conclusion: This review of literature published between 2015 and 2020 reveals persistent heterogeneity of hepatic IVC reconstructive techniques and peri-operative management. Increased utilization of ex vivo approaches and decreased use of venovenous bypass point towards improved operative techniques, peri-operative management, and anesthesia. In order to gain evidence for consensus on management, a registry would be beneficial.

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“…They showed that the ante situm liver resection can be safely performed in an experienced HPB center without hypothermia and veno-venous bypass [1]. However, we have some questions and comments:…”

mentioning

confidence: 95%

Critical appraisal of the modified ante situm liver resection

Fard-Aghaie

Kantas

Makridis

et al. 2019

Langenbecks Arch Surg

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Modified ante situm liver resection without use of cold perfusion nor veno-venous bypass for treatment of hepatic lesions infiltrating the hepatocaval confluence

Abstract: Ante situm liver resection can be applied without cold perfusion nor veno-venous bypass with acceptable morbidity and mortality. However, this procedure remains challenging even for the experienced hepato-pancreato-biliary surgeon.

Cited by 25 publications

References 21 publications

Ex vivo resection and temporary portocaval shunt of unresectable hepatocellular carcinoma followed by autotransplantation of liver: a case report

Ex vivo resection and temporary portocaval shunt of unresectable hepatocellular carcinoma followed by autotransplantation of liver: a case report

Current trends in vena cava reconstructive techniques with major liver resection: a systematic review

Critical appraisal of the modified ante situm liver resection

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