caa a22 4500 475802357 CHVBK 20180406123741.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s002689910060 doi (NATIONALLICENCE)springer-10.1007/s002689910060 Hepatic Vein Reconstruction by External Iliac Vein Graft Using Vascular Clips [Elektronische Daten] [Yuji Kaneoka, Akihiro Yamaguchi, Masatoshi Isogai, Akihiro Hori] The utility of hepatic vein reconstruction following resection of segments VII and VIII plus the right hepatic vein (RHV) is still controversial. The purpose of this study was to investigate the surgical benefits of hepatic vein reconstruction using stapled vascular clips and the draining area of hepatic vein using angiographic computed tomography (CT) to determine strict indications for hepatic vein reconstruction. Five patients underwent RHV reconstruction by external iliac vein graft using stapled vascular clips (VCS clips) following resection of segments VII and VIII, regardless of whether an inferior right hepatic vein (IRHV) was present. In eight other patients CT during arterial portography (CTAP) under temporary RHV occlusion using a balloon catheter was performed to determine the drainage area of the RHV. Operating times were 240 to 400 minutes (mean 336 ± 59 minutes), and the mean hepatic vein reconstruction time was 26 ± 5 minutes. There were no complications related to the surgery. Follow-up examinations showed patency of the graft in all cases; three patients are still alive with long-term graft patency of 10 to 24 months. CTAP under RHV occlusion demonstrated that segment VI and part of segment V were almost hypoattenuated in cases of absent or small IRHV, although those segments were hyperattenuated in thick IRHV and RHV-IRHV communicating patients. In conclusion, this anastomotic technique using vascular clips resulted in sound patency of the graft, which was accomplished by a simple technique. Preoperative CTAP with the RHV occlusion method can be useful for determining whether hepatic vein reconstruction is necessary. by the Société Internationale de Chirurgie, 2000 Kaneoka Yuji Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut Yamaguchi Akihiro Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut Isogai Masatoshi Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut Hori Akihiro Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut World Journal of Surgery Springer-Verlag 24/3(2000-03-01), 377-382 0364-2313 24:3<377 2000 24 268 https://doi.org/10.1007/s002689910060 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910060 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kaneoka Yuji Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut NATIONALLICENCE 700 1- Yamaguchi Akihiro Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut NATIONALLICENCE 700 1- Isogai Masatoshi Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut NATIONALLICENCE 700 1- Hori Akihiro Department of Surgery, Ogaki Municipal Hospital, Minaminokawa-cho, Ogaki 503-0864, Japan, JP aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/3(2000-03-01), 377-382 0364-2313 24:3<377 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer