TY - JOUR
T1 - Porto-Rex Shunt for Left Portal Vein Reconstruction During Right Extended Hepatectomy for Advanced Extrahepatic Biliary Cancer
AU - Lahat, Eylon
AU - Jaber, Ahmad
AU - Salloum, Chady
AU - Lim, Chetana
AU - Golan, Gil
AU - Ben-Ari, Ziv
AU - Gutman, Mordechai
AU - Azoulay, Daniel
N1 - Publisher Copyright:
© 2019, Société Internationale de Chirurgie.
PY - 2019/4/15
Y1 - 2019/4/15
N2 - Resection offers the only chance of long-term survival or cure for perihilar cancer, provided R0 resection is achieved with margin-negative status of the remnant liver, bile duct, proximal hepatic artery, and portal vein. End-to-end anastomosis of the portal trunk to the left portal branch is the conventional portal reconstruction in cases of right extended hepatectomy requiring resection of the portal vein bifurcation. This mandatory reconstruction may be challenging due to (1) vessel incongruence, (2) fragility of the left portal branch wall, and more importantly, and (3) the divergent orientation of the two vessels exposing to vascular twisting/kinking. We report here the first two cases of porto-Rex shunt, between the portal vein trunk and the left portal vein in the umbilical fissure during right extended hepatectomy for advanced extrahepatic biliary cancer: one following failed conventional portal reconstruction and one to achieve macroscopically complete resection.
AB - Resection offers the only chance of long-term survival or cure for perihilar cancer, provided R0 resection is achieved with margin-negative status of the remnant liver, bile duct, proximal hepatic artery, and portal vein. End-to-end anastomosis of the portal trunk to the left portal branch is the conventional portal reconstruction in cases of right extended hepatectomy requiring resection of the portal vein bifurcation. This mandatory reconstruction may be challenging due to (1) vessel incongruence, (2) fragility of the left portal branch wall, and more importantly, and (3) the divergent orientation of the two vessels exposing to vascular twisting/kinking. We report here the first two cases of porto-Rex shunt, between the portal vein trunk and the left portal vein in the umbilical fissure during right extended hepatectomy for advanced extrahepatic biliary cancer: one following failed conventional portal reconstruction and one to achieve macroscopically complete resection.
UR - http://www.scopus.com/inward/record.url?scp=85059555645&partnerID=8YFLogxK
U2 - 10.1007/s00268-018-04895-8
DO - 10.1007/s00268-018-04895-8
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C2 - 30610268
AN - SCOPUS:85059555645
SN - 0364-2313
VL - 43
SP - 1117
EP - 1120
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 4
ER -
