ArticleAnnals of surgical oncology2024
Complex Hepatectomy Under Total Vascular Exclusion of the Liver Preserving the Caval Flow with Portal Hypothermic Perfusion and Temporary Portacaval Shunt: A Proof of Concept.
Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Cadaveric training of total hepatic vascular exclusion for juxtahepatic venous injury: a technical study.Langenbeck's archives of surgery · 2026Article
- ASO Author Reflections: Could the Use of a Hypothermic Oxygenated Machine Perfusion Improve Postoperative Outcome After In Situ Hypothermic, Ante Situm, and Ex Situ Liver Resection?Annals of surgical oncology · 2025Article
- Left Hepatectomy Enlarged to Segment 1 with Total Vascular Exclusion of the Liver Preserving the Caval Flow with Temporary Portacaval Shunt and Hypothermic Oxygenated Portal Perfusion on Machine for Metastatic Recurrence of a Pleural Chondrosarcoma.Annals of surgical oncology · 2025Article
- Left hepatectomy extended to paracaval segment and anterior vena cava wall, with autologous venous graft reconstruction of middle hepatic vein under veno-venous bypass and "in situ" hypothermic liver perfusion: a surgical technique.Translational gastroenterology and hepatology · 2025Article
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9 authors.
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Abstract
backgroundHypothermic liver perfusion decreases ischemia/reperfusion injury during hepatectomy under standard total vascular exclusion (TVE) of the liver. This surgery needs venovenous bypass and is hampered by high morbi-mortality. TVE preserving the inferior vena cava (IVC) flow is hemodynamically well tolerated but remains limited in duration when performed under liver normothermia. The objective of this study was to report the results of TVE preserving the caval flow, modified to allow hypothermic liver perfusion and obviate splanchnic congestion. PATIENTS AND
methodsThe technique, indicated for tumors abutting large tributaries of the hepatic veins but sparing their roots in IVC and the latter, was applied when TVE was anticipated to last for ≥ 60 min. It combines continuous TVE preserving the IVC flow with hypothermic liver perfusion and temporary portacaval shunt (PCS). Results are given as median (range).
resultsVascular control was achieved in 13 patients with excellent hemodynamical tolerance. PCS was direct or via an interposed synthetic graft (five and eight cases, respectively). Liver temperature dropped to 16.5 (6-24) °C under perfusion of 2 (2-4) L of cold perfusate. TVE lasted 67 (54-125) min and 4.5 (0-8) blood units were transfused. Resection was major in nine cases and was complete in all cases. Five complications occurred in four patients, and the 90-day mortality rate was zero.
conclusionsThis technique maintains stable hemodynamics and combines the advantages of in situ or ex situ standard TVE with hypothermic liver perfusion, without their inherent prolongation of ischemia time and need for venovenous bypass.
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