Right inferior phrenic vein indicating the right hepatic vein confluence into the inferior vena cava

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• 作者：Guido Torzilli ; Marco Montorsi ; Angela Palmisano ; Daniele Del Fabbro ; Andrea Gambetti ; Matteo Donadon ; Natale Olivari and Masatoshi Makuuchi
• 刊名：The American Journal of Surgery
• 出版年：2006
• 出版时间：November 2006
• 年：2006
• 卷：192
• 期：5
• 页码：690-694
• 全文大小：4522 K

文摘

Background

Limiting backflow bleeding from the hepatic veins is a priority when performing hepatectomy. However, hepatic vein encirclement is difficult, especially in re-resection. We verified the presence and trajectory of the right inferior phrenic vein (RIPV), which could be a useful anatomic landmark to guide surgeons in targeting the extrahepatic right hepatic vein (RHV) before dissection.

Methods

Between May 2001 and January 2005, 100 consecutive patients with liver tumors were enrolled and underwent hepatectomy: 77 patients underwent surgery for tumors located in the right hemiliver.

Results

RIPV was detected in all but 1 patient (99 % ), and its trajectory was always guided toward the extrahepatic RHV. The only patient in whom RIPV was not detected had undergone prior liver resection and interstitial therapies for colorectal cancer liver metastases.

Conclusions

Apart from exceptional conditions, detection of the RIPV is always feasible and allows safe surgical dissection while approaching the extrahepatic RHV before hepatic resection.