[Combined resection of liver and inferior vena cava]

Abstract

It was analyzed the results of treatment of 8 patients. Combined resection of liver and inferior vena cava was done in all cases. All resections of inferior vena cava were performed in combination with right-sided hemihepatectomy. Circular resection of inferior vena cava was done in 6 cases, tangential-in 2 cases. Allograft of donor inferior vena cava was used in 3 cases for reconstruction of inferior vena cava. Average duration of combined resection of liver and inferior vena cava was 675±189 min, average hemorrhage - 1800±1402 ml. The need for transfusion of packed red blood cells was 270±723 ml, the need for transfusion of fresh frozen plasma was 1105±636 ml. Post-resection liver failure according to criteria ISGLS developed in 3 patients (37.5%). Biliary complications such as biliary fistula and inconsistency of hepatico-jejunal anastomosis developed in 2 patients (25%). Hospital mortality was 12.5%. It is considered that resection of liver with inferior vena cava demands an experience in hepatobiliary surgery and/or liver transplantation. Surgeon must be ready to use total vascular isolation, hypothermic preservation and veno-venous bypass grafting. It allows to dilate an opportunity of resection liver surgery.