Extended left hepatectomy for intrahepatic cholangiocarcinoma: hepatic vein reconstruction with in-situ hypothermic perfusion and extracorporeal membrane oxygenation

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dc.contributor.advisorAkar, Ahmet Ruchan
dc.contributor.authorBalcı, Deniz
dc.contributor.departmentTıp Fakültesitr_TR
dc.contributor.otherÖzçelik, Menekşe
dc.contributor.otherKırımker, Elvan Onur
dc.contributor.otherÇetinkaya, Arda
dc.contributor.otherÜstüner, Enver
dc.contributor.otherÇakıcı, Mehmet
dc.contributor.otherİnan, Bahadır
dc.contributor.otherAlanoğlu, Zekeriyya
dc.contributor.otherBilgiç, Sadık
dc.date.accessioned2020-03-16T09:04:33Z
dc.date.available2020-03-16T09:04:33Z
dc.date.issued2018
dc.description.abstractBackground Liver resection for intrahepatic cholangiocarcinoma (ICC) with invasion of the inferior vena cava (IVC) and hepatic veins (HV) is a challenging procedure. Case presentation We report a case of a 63-year-old woman with a 6-cm, centrally located liver mass. Her biochemistry results were normal except for a Ca19–9 level of 1199 U/ml. The liver biopsy was consistent with ICC and 60% macrosteatosis. Abdominal CT scans revealed a large central mass invading the left HV, middle HV and right HV, infringing on their junction with the vena cava. An operation was planned using a 3-dimensional (3D) computer simulation model using dedicated software. We also describe a novel veno-portal-venous extracorporeal membrane oxygenation (VPV-ECMO) support with in-situ hypothermic perfusion (IHP) during this procedure. We aimed to perform an extended left hepatectomy and reconstruct 3 right HV orifices with an interposition jump graft to the IVC with total vascular exclusion (TVE) and IHP A supplemental video describing the preoperative planning, the operative procedure with the postoperative follow-up in detail is presented. After the patient was discharged, she developed a hepatic venous outflow obstruction 3 months postoperatively, which was effectively managed with hepatic venous stenting by interventional radiology. She is currently symptom free and without tumour recurrence at the 1-year follow-up. Conclusions This report demonstrates that extended left hepatectomy for IHC with IHP and VPV-ECMO is safe and feasible under the supervision of a highly experienced team. Electronic supplementary material The online version of this article (10.1186/s12893-018-0342-2) contains supplementary material, which is available to authorized users.tr_TR
dc.identifier.endpage5tr_TR
dc.identifier.issue7tr_TR
dc.identifier.startpage01tr_TR
dc.identifier.urihttps://doi.org/10.1186/s12893-018-0342-2tr_TR
dc.identifier.urihttp://hdl.handle.net/20.500.12575/70634
dc.identifier.volume18tr_TR
dc.language.isoentr_TR
dc.relation.isversionof10.1186/s12893-018-0342-2tr_TR
dc.relation.journalBMC Surgtr_TR
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.subjectIntrahepatic cholangiocarcinomatr_TR
dc.subjectECMOtr_TR
dc.subjectTotal vascular exclusiontr_TR
dc.titleExtended left hepatectomy for intrahepatic cholangiocarcinoma: hepatic vein reconstruction with in-situ hypothermic perfusion and extracorporeal membrane oxygenationtr_TR
dc.typeArticletr_TR

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