Reconstruction of hepatic venous tributaries using a Y-shaped left portal vein graft harvested from a resected left liver.

Hepatic vein resection and reconstruction after major hepatectomy is a technically feasible but controversial procedure. Reported autologous vein grafts include the great saphenous, external iliac vein, superficial femoral, gonadal, left renal and inferior mesenteric veins. The procedures required to obtain these grafts, however, are associated with a risk of postoperative morbidity such as edema of the lower leg. We performed the reconstruction of two middle hepatic vein (MHV) branches by using an autologous left portal vein graft that was harvested with its tributaries from the left hepatectomy specimen in a 57-year-old man who had undergone a sigmoidectomy for colon cancer and a partial resection of the right lateral sector of the liver for a metastasis. In conclusion, this is the first report on the reconstruction of MHV tributaries using a single autologous Y-shaped portal vein graft during a hepatectomy. This method produces no complications related to the harvesting of the graft.