首页|First Affiliated Hospital of Chongqing Medical University Reports Findings in Li ver Failure (Portal Vein Arterialization as a Lifesaving Strategy for Hepatic Ar tery Injury in Robotic Hepatectomy)
First Affiliated Hospital of Chongqing Medical University Reports Findings in Li ver Failure (Portal Vein Arterialization as a Lifesaving Strategy for Hepatic Ar tery Injury in Robotic Hepatectomy)
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By a News Reporter-Staff News Editor at Robotics & Machine Learning Daily News Daily News-New research on Liver Diseases and Con ditions - Liver Failure is the subject of a report. According to news reporting from Chongqing, People's Republic of China, by NewsRx journalists, research stat ed, "Robotic vascular resection and reconstruction is a challenging procedure. P ortal vein arterialization (PVA) can offer an efficient solution in those cases in which the hepatic artery cannot be reconstructed.1.Can J Surg 64:e173-e182;2. The Paul Brousse Hospital Experience." The news correspondents obtained a quote from the research from the First Affili ated Hospital of Chongqing Medical University, "HPB (Oxford) 16:723-738;3.J Am C oll Surg 207:e1-6; PVA increases oxygen supply to the remaining part of the live r, promotes liver regeneration, and prevents liver failure. Majlesara A, Golriz M , Ramouz A, et al. Portal vein arterialization as a salvage method in advanced h epatopancreatobiliary surgery. Br J Surg. 2024;111. In this multimedia article, we describe a patient who was treated with PVA for a robotic hepatic artery inju ry during robotic left-liver-first anterior radical modular orthotopic right hem ihepatectomy (Rob-Larmorth).5.Ann Surg Oncol 31:5636-5637 METHODS: A 52-year-old male patient was admitted with epigastric pain. Further imaging showed intrahep atic cholangiocarcinoma involving the root of the right anterior branch of the p ortal vein. Following multidisciplinary consultation, surgical resection was rec ommended as the primary approach. The robotic technique was chosen in this opera tion, with preoperative anticipation of needing Rob-Larmorth. Unfortunately, the left hepatic artery sustained unintended damage during skeletonization of the d uodenal ligaments. Anastomosis could not be performed due to severe damage to th e distal end intima. We utilized PVA technology to anastomose the hepatic artery to the portal vein. Finally, Rob-Larmorth and PVA were successfully performed. The surgery took 490 min and the estimated blood loss was approximately 300 mL. No blood transfusion was performed. Postoperatively, the patient recovered smoot hly without liver failure, although percutaneous drainage was required due to bi le leakage. Pathological examination revealed moderately to poorly differentiate d bile duct cell carcinoma (T2N0M0, stage II). No recurrence was observed during the 12-month follow-up. PVA can be an effective solution when no other revascul arization options are available. Implementing PVA as a bridging procedure increa ses oxygen delivery to the remnant liver, facilitating regeneration and reducing the risk of liver failure. The development of arterial collaterals is a signifi cant concern for individuals undergoing PVA. Complications reported after PVA in clude early shunt thrombosis, portal hypertension, and a notable 90-day mortalit y rate.1.Can J Surg 64:e173-e182 However, Majlesara and colleagues found no evid ence of postoperative liver damage associated with PVA. They also reported low m orbidity rates and no associated mortality for both one- and two-stage embolizat ion of the arterioportal shunt.Majlesara A, Golriz M, Ramouz A, et al. Portal ve in arterialization as a salvage method in advanced hepatopancreatobiliary surger y. Br J Surg. 2024;111."
ChongqingPeople's Republic of ChinaA siaAngiologyDigestive System Surgical ProceduresEmerging TechnologiesGas troenterologyHealth and MedicineHepatectomyHepatic ArteryHepatic Insuffi ciencyHepatologyLiver Diseases and ConditionsLiver FailureMachine Learni ngPortal VeinRisk and PreventionRoboticsRobotsSurgery
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