Central-Located Massive Tumor With Inflow And Out flow Reconstruction For Massive Hepatectomy - A Case Report = Central-Located Massive Tumor With Inflow And Out flow Reconstruction For Massive Hepatectomy - A Case Report

다국어 초록 (Multilingual Abstract)

Aims: Right trisectionectomy was the most effective curative treatment with massive tumor located in the right lobe especially central location of liver. Due to the compressing or even invasion from huge tumor to main branches of portal vein, hepatic vein and bile duct, adequate consideration of inflow and outflow reconstruction during surgery was needed and vessels acquired from cadaveric donor or artificial should be prepared preoperatively.
Methods: We present the case of a 59-year-old man who found a 10 cm malignant mass in the right lobe with the invasion of right anterior portal vein, right hepatic vein and middle hepatic vein. By performing right portal vein embolization, left lateral section volume was increased from 26.5% to 37.3%, satisfy the condition of right trisectionectomy. Outflow reconstruction was performed using pericardium, which was acquired from previous cadaveric donor.
Results: The recovery process was smooth, patient was discharged in POD 58 without any complication,
Conclusions: Preoperatively, sufficient consideration of using allograft to perform inflow or outflow reconstruction is needed in patient with vascular invasion. Postoperatively, regular hepatic mesenteric doppler F/U is needed. Usage of allograft is limited in the hospital where cadaveric donor liver transplantation is feasible. Thus, artificial graft should be prepared in the vascular invasion cases.