Wu G, Jiang JP, Cheng DH, Yang C, Liao DX, Liao YB, Lau WY, Zhang Y. Novel liver vein deprivation technique that promotes increased residual liver volume (with video): A case report. World J Clin Cases 2022; 10(31): 11579-11584 [PMID: 36387803 DOI: 10.12998/wjcc.v10.i31.11579]
Corresponding Author of This Article
Yu Zhang, MD, Associate Professor, Department of Hepatobiliary Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, No. 32 Yihuan Road, Chengdu 610072, Sichuan Province, China. 68532815@qq.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Gang Wu, Ji-Peng Jiang, Dong-Hui Cheng, Dong-Xu Liao, Yu-Bo Liao, Yu Zhang, Department of Hepatobiliary Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
Chong Yang, Organ Transplantation Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
Wan-Yee Lau, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hongkong 999077, China
Author contributions: Lau WY, Liao YB and Wu G contributed to manuscript writing and editing, and data collection; Jiang JP, Cheng DH, Yang C and Liao DX contributed to data analysis; Zhang Y contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: All procedures performed in this study that involved human participants were performed in accordance with the ethical standards of the Human Subjects Committee of the Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Zhang, MD, Associate Professor, Department of Hepatobiliary Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, No. 32 Yihuan Road, Chengdu 610072, Sichuan Province, China. 68532815@qq.com
Received: June 29, 2022 Peer-review started: June 29, 2022 First decision: September 5, 2022 Revised: September 9, 2022 Accepted: September 29, 2022 Article in press: September 29, 2022 Published online: November 6, 2022 Processing time: 120 Days and 1.3 Hours
Abstract
BACKGROUND
Inadequate volume of future liver remnant (FLR) is a major challenge for hepatobiliary surgeons treating large or multiple liver tumors. As an alternative to associating liver partition and portal vein ligation (ALPPS) for staged hepatectomy and liver venous deprivation (LVD) using stage 1 interventional radiology for vascular embolization combined with stage 2 open liver resection have been used.
CASE SUMMARY
A novel modified LVD technique was performed in a patient with pancreatic neuroendocrine tumor with liver metastases by using stage 1 laparoscopic ligation of the right hepatic vein, right posterior portal vein, and short hepatic veins combined with local excision of three liver metastases in the left hemiliver. The operation was followed three days later by interventional radiology to embolize an anomalous right anterior portal vein to complete LVD. A stage 2 laparoscopic right hemihepatectomy and pancreaticosplenectomy were then carried out.
CONCLUSION
The minimally invasive technique promoted a rapid increase, comparable to ALPPS, in volume of the FLR after the stage 1 operation to allow the laparoscopic stage 2 resection to be performed.
Core Tip: A novel modified technique of liver venous deprivation was carried out in a patient with pancreatic neuroendocrine tumor with liver metastases by using stage 1 laparoscopic ligation of right hepatic vein, right posterior portal vein and short hepatic veins combined with local excision of 3 liver metastases in left hemiliver.
