Higashi H, Abe Y, Abe K, Nakano Y, Tanaka M, Hori S, Hasegawa Y, Yagi H, Kitago M, Kitagawa Y. Novel procedure for hepatic venous outflow block after liver resection: A case report. World J Clin Cases 2024; 12(29): 6320-6326 [DOI: 10.12998/wjcc.v12.i29.6320]
Corresponding Author of This Article
Yuta Abe, MD, PhD, Senior Lecturer, Surgeon, Department of Surgery, Keio University School of Medicine, No. 35 Shinanomachi, Tokyo 160-8582, Japan. abey3666@gmail.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/
World J Clin Cases. Oct 16, 2024; 12(29): 6320-6326 Published online Oct 16, 2024. doi: 10.12998/wjcc.v12.i29.6320
Novel procedure for hepatic venous outflow block after liver resection: A case report
Hisanobu Higashi, Yuta Abe, Kodai Abe, Yutaka Nakano, Masayuki Tanaka, Shutaro Hori, Yasushi Hasegawa, Hiroshi Yagi, Minoru Kitago, Yuko Kitagawa
Hisanobu Higashi, Department of Surgery, National Hospital Organization Saitama Hospital, Wako 351-0102, Japan
Hisanobu Higashi, Yuta Abe, Kodai Abe, Yutaka Nakano, Masayuki Tanaka, Shutaro Hori, Yasushi Hasegawa, Hiroshi Yagi, Minoru Kitago, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
Author contributions: Higashi H and Abe Y reviewed the literature, contributed to manuscript drafting, reviewed computed tomography scans, and selected the figures; Abe K, Nakano Y, Tanaka M, Hori S, Hasegawa Y, Kitago M, and Kitagawa Y reviewed the literature; Abe Y was responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflict-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: Yuta Abe, MD, PhD, Senior Lecturer, Surgeon, Department of Surgery, Keio University School of Medicine, No. 35 Shinanomachi, Tokyo 160-8582, Japan. abey3666@gmail.com
Received: May 9, 2024 Revised: June 29, 2024 Accepted: July 15, 2024 Published online: October 16, 2024 Processing time: 110 Days and 18.6 Hours
Abstract
BACKGROUND
Postoperative complications like remnant hepatic vein (HV) outflow block and liver torsion can occur after right hepatectomy. Hepatic falciform ligament fixation is typically used to prevent liver torsion. We report a novel procedure to manage outflow block.
CASE SUMMARY
An 80-year-old man developed HV outflow block after remnant right hepatectomy, despite liver fixation and intraoperative HV flow check. He had a history of cholangiocellular carcinoma and had undergone posterior segmentectomy and choledojejunostomy. The falciform ligament fixation was inadequate to maintain liver position. Emergency surgery was performed, using an omental flap and mobilized right side colon with ileocecal region to prevent liver dislocation due to intraabdominal adhesion. His postoperative course was uneventful.
CONCLUSION
This is the first report providing a novel surgical procedure when the falciform ligament is insufficient for remnant liver fixation.
Core Tip: This report presents a case of an 80-year-old man who developed hepatic vein outflow block post right hepatectomy. Despite standard falciform ligament fixation, the remnant liver dislocated due to intraabdominal adhesion. An emergency operation using an omental flap and mobilized right side colon successfully managed the outflow block. This novel procedure provides a solution when the falciform ligament is insufficient for liver fixation.
