Total resection of the right hepatic vein drainage area with the aid of three-dimensional computed tomography

Taketomi, Akinobu; Takeishi, Kazuki; Mano, Yohei; Toshima, Takeo; Mizutani, Takashi; Aishima, Shinichi; Uchiyama, Hideaki; Yoshizumi, Tomoharu; Shirabe, Ken; Maehara, Yoshihiko

doi:10.1007/s00595-011-0021-8

Cited by 10 publications

(4 citation statements)

References 19 publications

(24 reference statements)

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“…For conventional RPS graft retrieval (cases 1, 4, and 5), the posterior Glissonian pedicle was clamped, and the objective area was recognized from the surface of the liver. For cases 2, 3, and 6 to 8, the drainage area of the RHV was harvested as an extended RPS graft . The drainage area of the RHV was included in the graft and was recognized by the discoloration of the liver surface when the right HA and the RHV were clamped simultaneously.…”

Section: Methodsmentioning

confidence: 99%

“…For cases 2, 3, and 6 to 8, the drainage area of the RHV was harvested as an extended RPS graft. 15 The drainage area of the RHV was included in the graft and was recognized by the discoloration of the liver surface when the right HA and the RHV were clamped simultaneously. The right liver was mobilized by the division of each short hepatic vein.…”

Section: Graft Retrieval Techniquementioning

confidence: 99%

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Selection of a right posterior sector graft for living donor liver transplantation

et al. 2014

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Right posterior sector (RPS) grafts have been used to overcome graft size discrepancies, the major concern of living donor liver transplantation. Previous studies have reported the volumetry-based selection of RPS grafts without anatomical exclusion. We reviewed our data and established selection criteria for RPS grafts. The procurement of RPS grafts [conventional (n 5 3) and extended (n 5 5)] was performed for 8 of 429 recipients at our center. Extended RPS grafts contained the drainage area of the right hepatic vein. The mean graft weight (GW) according to 3-dimensional computed tomography volumetry was 488 g, and the GW/standard liver weight (SLW) ratio was 42.6%. The mean actual GW was 437 g, and the GW/SLW ratio was 38.4%. One donor exhibited standard bifurcation of the right portal vein (PV) and the left PV, and 2 donors exhibited trifurcation of the left PV, the right anterior portal vein (APV), and the posterior PV. The remaining 5 donors exhibited APV branching from the left PV, which is the most suitable anatomy for RPS grafts. Two recipients died of sepsis or small-for-size graft syndrome. One underwent retransplantation because of an intractable bile leak and fibrosing cholestatic hepatitis. Intractable bile duct (BD) stenosis developed in 4 of the 6 survivors. In conclusion, with the significant complications and potential concerns associated with RPS grafts, these grafts should be used very rarely and with extreme caution. See Editorial on Page 1019Since a 1994 report demonstrating successful living donor liver transplantation (LDLT) between adults, 1 living donors have been increasingly used because of the disparity between the demand and the supply.Right lobe (RL) grafts, which account for >60% of the total liver mass, are the allografts most commonly used for LDLT. Although our previous reports have indicated an average hospital stay of <14 days and the performance of living donation without the need for nonautologous blood transfusions, 2,3 serious donor complications and death are possible. In the

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Section: Methodsmentioning

confidence: 99%

Section: Graft Retrieval Techniquementioning

confidence: 99%

Selection of a right posterior sector graft for living donor liver transplantation

et al. 2014

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“…Especially in the liver, diagnostic imaging offers diverse modalities, including noninvasive evaluations [5,6,7,8,9,10,11,12,13,14]. Many types of imaging softwares using multiplanar reconstruction (MPR) have become available for the diagnosis and/or treatment guidance for liver cancers [15,16,17,18]. …”

Section: Introductionmentioning

confidence: 99%

Virtual Sonography for Novice Sonographers: Usefulness of SYNAPSE VINCENT® with Pre-Check Imaging of Tumor Location

et al. 2014

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Purpose: To evaluate the usefulness of a virtual ultrasound (US) imaging device as a tool to assist novice sonographers. Materials and Methods: A prospective blinded pilot study was conducted involving patients with liver lesions. Two sonographers and 2 medical doctors with less than 5 years of experience performed US examinations. The time needed to detect liver lesions on US and the success rate for detecting liver lesions with and without using the virtual US imaging device SYNAPSE VINCENT® (Fujifilm Medical Co., Tokyo, Japan) before US examination were evaluated. Results: Thirty-two patients with the following 42 liver lesions were included: liver cyst (n = 24), hemangioma (n = 8), hepatocellular carcinoma (n = 6), and liver metastasis (n = 4). The maximal diameter of these lesions ranged from 0.3 to 1.5 cm (mean ± SD, 0.8 ± 0.4). The average time for detecting liver lesions on US was 47.8 s (range, 7-113) with VINCENT and 112.9 s (range, 14-313) without VINCENT before US examination. There were significant differences in the duration of US examination with and without VINCENT (p = 0.0002, Student's t test). The rates for accurately detecting liver lesions were 100 and 76.2% (16/21) in US beginners with and without VINCENT, respectively. Significantly higher detection rates were found in the US beginners who used VINCENT compared to those who did not use VINCENT (p = 0.047, Fisher's exact test). Conclusion: Before US examination, a reference with VINCENT could contribute to the successful detection of liver lesions and could be time-saving for US beginners.

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“…To overcome these disadvantages, the first US navigation system real-time virtual sonography (RVS) was developed by Hitachi Aloka Medical (Tokyo, Japan) in 2003 [9]. Various imaging software products using multiplanar reconstruction are available for the diagnosis of HCC and guiding treatment decisions [10,11,12]. Navigation systems are able to increase operator comprehension of the 3D relationship between the liver vasculature and tumors.…”

Section: Introductionmentioning

confidence: 99%

Initial Experience Performing Percutaneous Ultrasound Examination with Real-Time Virtual Sonography with Color Display

Ogawa

Minami²,

Noda³

et al. 2015

Oncology

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Purpose: We report the efficacy of percutaneous ultrasound (US) examination using a novel real-time virtual sonography (RVS) method that collates multiple Digital Imaging and Communications in Medicine (DICOM) data sources and displays reference images in color. Materials and Methods: A total of 7 patients with 9 hepatocellular carcinomas were evaluated. Using the SYNAPSE VINCENT volume analyzer, DICOM data of the portal vein, hepatic vein, tumor, and hepatic segment were isolated from contrast-enhanced computed tomography DICOM data. Each portion of DICOM data was uploaded into an US scanner (HI VISION Ascendus, Hitachi Aloka Medical Ltd., Tokyo, Japan) and unified on a US platform to create a single reference image. Each uploaded portion of DICOM data was assigned a different color. Further, conventional RVS was performed using this information. Results: The maximal tumoral diameter ranged from 6.4 to 15 mm (mean ± SD, 11.0 ± 2.8). DICOM data could be isolated, enabling the display of color RVS in all patients. Color RVS facilitated superior visibility compared with conventional grayscale RVS and facilitated the comprehension of spatial positioning. Conclusion: RVS with color display demonstrates utility in increasing operator comprehension of spatial and positional relationships during percutaneous US examination.

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Total resection of the right hepatic vein drainage area with the aid of three-dimensional computed tomography

Abstract: THR-RHV allowed for a higher remnant liver volume than that after conventional right lobectomy of the liver, and proved feasible with acceptable perioperative results. This technique thus promotes both safety and curability for patients with a tumor close to the RHV.

Cited by 10 publications

References 19 publications

Selection of a right posterior sector graft for living donor liver transplantation

Selection of a right posterior sector graft for living donor liver transplantation

Virtual Sonography for Novice Sonographers: Usefulness of SYNAPSE VINCENT® with Pre-Check Imaging of Tumor Location

Initial Experience Performing Percutaneous Ultrasound Examination with Real-Time Virtual Sonography with Color Display

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