A simplified approach to hepatic vein injuries.

Hepatic vein injuries continue to be difficult and frustrating problems, presenting any surgeon with a formidable challenge. However, this simplified approach can be used successfully in many patients. It does not require extensive dissection and cannulation of the inferior vena cava, and it is more applicable for surgeons with limited vascular experience, who occasionally encounter an injury of this magnitude. Obviously, it is not suitable for all patients with hepatic vein trauma, especially those with extensive caval involvement which does require shunting and exclusion procedures. However, one should evaluate thoroughly the magnitude of the injury and strongly consider this simplified approach before selecting a technically more difficult method which may not be required and which may result in a fatal complication if not executed properly.