Modified Vascular Exclusion Method for Hepatectomy and Thrombectomy for Hepatocellular Carcinoma with Tumor Thrombus in the Vena Cava

Toshiaki Nonami, Akimasa Nakao, Itsuo Yokoyama, Akio Harada, Tsuyoshi Kurokawa, Yuuya Murakami, Akihito Torii, Eisaku Hiraoka, Hiroshi Takagi

Second Department of Surgery, Nagoya University School of Medicine

Hepatocellular carcinoma with a tumor thrombus was resected by the modified vascular exclusion method. The tumor thrombus in the vena cava extended from the right hepatic vein to part of the diaphragma. Thrombectomy with vascular exclusion on a veno-venous bypass was followed by right hepatic lobectomy without a venovenous bypass in order to saving the time of hepatic ischemia. Hepatic perfusion was not used because the time of vascular exclusion was as short as 27 minutes. The patient had no clinical problems during the postoperative period. This method is useful for resection of hepatocellular carcinoma with a tumor thrombus in the vena cava.

Key words
hepatocellular carcinoma with tumor thrombus in the vena cava, hepatectomy, veno-venous bypass

Reprint requests
Toshiaki Nonami Second Department of Surgery, Nagoya University School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466 JAPAN

Accepted
December 9, 1992

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