Surgical treatment of extensive hepatic alveolar echinococcosis using a three-dimensional visualization technique combined with allograft blood vessels

Abstract

Rationale: Hepatic alveolar echinococcosis (HAE) presents a high pathogenicity and case fatality rate. The main treatment for HAE is surgical resection. Giant lesions in the liver and invasion of the pathogen into the retrohepatic inferior vena cava are usually associated with a poor prognosis when radical resection cannot be performed. Patient concerns: A 56-year-old man who underwent hydatidectomy 7 years prior noted a recurrence of HAE. He was subsidized and admitted to our hospital for the purpose of surgical treatment. Diagnosis: By computed tomography, angiography and three-dimensional (3D) computed tomography reconstruction images, multiple, giant HAE with 75% stenosis was confirmed. Interventions: With the 3D visualization technique, we designed the surgical plan and performed radical resection of the lesions, including the invaded inferior vena cava, and maximized retention of normal liver tissue. The abdominal aorta of an organ donor was used for vascular allograft reconstruction. Outcomes: The patient recovered gradually after the operation. He was followed up for 3 months, and the reconstructed vein patency was good. Lessons: The 3D visualization technique combined with a blood vessel allograft allowed us to expand indications for radical resection of extensive HAE.

Clinical efficacy and safety of 3D vascular reconstruction combined with 3D navigation in laparoscopic hepatectomy: systematic review and meta-analysis

“…At present, the application of preoperative 3D reconstruction in PHC surgery (9). However, most of the published clinical studies are single-center and smallsample studies, and there is a lack of multicenter and large-sample randomized controlled trials.…”

Silent Rupture in the Inferior Vena Cava: A Complication Not to Be Ignored in the Presence of a Segment I Hydatid Cyst

“…This particular localization makes surgery for hydatid cysts, which is normally straightforward, highly complicated, sometimes necessitating vascular exclusion maneuvers [ 4 ]. The risk of flooding the operating field makes puncture of segment I cysts with cava contact inadvisable, and in most cases requires control of the IVC under and over the liver, thus, we used cardiopulmonary bypass to ensure a dry surgical field and to avoid a contamination risk [ 12 ]. Prosthetic reconstruction must be systematically anticipated and depends on preoperative reconstruction and intraoperative data, which allow judging the percentage of the circumference of the vena cava affected.…”