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HPB Surgery
Volume 2 (1990), Issue 2, Pages 121-127
http://dx.doi.org/10.1155/1990/97192

Juxtacaval Liver Resections with the Use of an Internal IVC Shunt Tube

1National Matsudo Hospital, Matsudo, Chiba, Japan
2National Cancer Centre Hospital, Tokyo, Japan
3Department of Surgery, National Matsudo Hospital, 123-1 Takatsukashinden, Matsudo, Chiba 271, Japan

Received 17 January 1989

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Almost one tenth of more than 370 hepatectomies, mostly for tumors, involved resection of major parts of the caudate lobe, subsegment 1. Five of them were for tumors or hemangiomas here, compressing or invading the vena cava; two were for metastases of colorectal cancer located very close to the junctions of the right and middle hepatic veins with the vena cava. We would previously have deemed these tumors unresectable. In these patients the vein was banded above and below the liver, an internal shunt tube placed in preparation for shunting of blood, and the afferent liver blood flow controlled. Control of the vena cava by tightening of the bands was needed in two cases. Tumor-invaded parts of the vein wall were resected in two other cases, in whom the presence of the tube facilitated the resection but the bands did not have to be tightened. The procedure did not cause morbidity and we conclude that tumors close to the vena cava can often be resected without complex vascular exclusion techniques, even when they invade the vein.