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- W3208246504 abstract "Introduction: Vascular iatrogenic injuries are one of the most frightening complications during hepatic surgery and we must be prepared to make an appropriate management regardless of surgical approach. Methods: We present the case of a 63 years old male with a laparoscopic sigmoidectomy due to stenosing adenocarcinoma with multiple bilobar liver metastases. After receiving conversion chemotherapy, he presented significant shrinkage of hepatic tumor burden. After multidisciplinary assessment, he was eligible for surgery (laparoscopic right posterior sectionectomy for metastases located in VI and VII segments + parenchymal-sparring hepatectomy of 3 metastases located in VIII, IV-B and III segments). We started doing right posterior sectionectomy using ultrasonic dissector and CUSA device. During liver transection, right hepatic vein was accidentally injured, causing a 1.5 cm laceration near its insertion into inferior cava vein. We repaired the laceration with continuous suturing using polypropylene 4/0. Once laceration was repaired, we verified there was no bleeding by increasing central vein pressure. We placed a Tachosil sheet over the suture and continued performing planned surgery without new events. Results: The patient was discharged on postoperative day six without any complication. Conclusion: We must be able to make and appropriate laparoscopic management of vascular iatrogenic injuries. Conversion to open surgery will create a pressure disbalance that could generate a dangerous massive bleeding. In this case, thanks to intraabdominal high pressure generated by pneumoperitoneum and maintaining a low central vein pressure we were able to repair this severe vascular injury without significant bleeding." @default.
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- W3208246504 date "2021-01-01" @default.
- W3208246504 modified "2023-09-27" @default.
- W3208246504 title "Right hepatic vein iatrogenic injury and repair during laparoscopic liver resection" @default.
- W3208246504 doi "https://doi.org/10.1016/j.hpb.2021.08.717" @default.
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