Ex Situ Resection of the Inferior Vena Cava with Hepatectomy
Tumours involving all of the major hepatic veins with or without IVC invasion, and particularly tumours involving the hepatocaval confluence and needing IVC replacement, continue to pose a surgical challenge, particularly if portal hilar structures are involved bilaterally. Ex situ resection is a potential mode of intervention performed in only a few liver surgery centres. Experience remains limited and there is a paucity of studies detailing this complex procedure in terms of patient selection, radiological assessment and pre-, intra- and postoperative strategies and addressing the potential for high morbidity and mortality. The short- and long-term outcomes can only be derived from only a small number of patients that have been reported. This chapter reviews the current experience in the context of contemporary hepatobiliary practice. Case studies with illustrations and a video are provided to supplement the content.
KeywordsPortal Vein Liver Resection Inferior Vena Cava Hepatic Vein Biliary Tract Cancer
(MOV 60931 kb) Video showing hepatectomy with IVC resection for extensive colorectal metastases
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