Sano Tsuyoshi, Shimada Kazuaki, Nara Satoshi, Sakamoto Yoshihiro, Kosuge Tomoo
Division of Hepatobiliary and Pancreatic Surgery, National Cancer Center Central Hospital, Chuou-ku, Tokyo 104-0045, Japan.
Hepatogastroenterology. 2008 Jan-Feb;55(81):228-30.
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.
肝切除术后肝静脉切除与重建是一项技术上可行但存在争议的手术。报道的自体静脉移植物包括大隐静脉、髂外静脉、股浅静脉、性腺静脉、左肾静脉和肠系膜下静脉。然而，获取这些移植物所需的手术与术后发病风险相关，如下肢水肿。我们在一名57岁男性患者中，使用自体左门静脉移植物及其分支进行了两根肝中静脉（MHV）分支的重建，该患者因结肠癌接受了乙状结肠切除术，并因转移灶接受了肝右外侧叶部分切除术。左门静脉移植物取自左肝切除标本。总之，这是关于肝切除术中使用单一自体Y形门静脉移植物重建MHV分支的首例报道。该方法不会产生与移植物获取相关的并发症。
