A Novel Technique for Resection of Huge Right Lobe Hepatocellular Carcinoma Extending to the Right Atrium: In-Situ Cold Perfusion of Liver

作者：Lin Chia Cheng; Lin Kuo Hua; Hung Yu Ju; Chen Yao Li^*

来源：Hepato-Gastroenterology, 2014, 61(134): 1677-1679.

• cold perfusion
• hepatocellular carcinoma
• right atrium

Background/Aims: Surgery for advanced hepatocellular carcinoma with inferior vena cava or right atrium extension represents challenging procedures for hepatobiliary surgeons. Regardless of the surgical approach chosen, the liver parenchyma inevitably has to suffer from ischemia during the total hepatic vascular exclusion period. Methodology: We report our novel technique for resection of a huge hepatocellular carcinoma extending to the right atrium. During the total hepatic vascular exclusion period, in-situ cold perfusion of the liver was performed in order to minimize the ischemic insults. Results: The 53-year-old male patient with chronic hepatitis B was diagnosed to have a huge right lobe hepatocellular carcinoma, besides which the tumor had invaded the right hepatic vein and right atrium. With the help of cardio-pulmonary bypass and in-situ cold perfusion of the liver, the tumor was removed en-bloc. The operating time was 458 minutes. The cold ischemia time of the liver was 53 minutes 30 seconds. The cardio-pulmonary bypass time was 61 minutes. The estimated blood loss was about 7000 ml. The patient was discharged under stable condition on postoperative day 35. Conclusions: In selected patients, when the expected tumor resection time is long, the in-situ cold perfusion of the liver could be considered an option.

• 出版日期2014-9