Delhorme JB, Méméo R, Marescaux J, Pessaux P. Preoperative detection of intrahepatic venovenous shunt treated by microwave precoagulation during right hepatectomy. World J Gastrointest Pharmacol Ther 2015; 6(4): 253-256 [PMID: 26558160 DOI: 10.4292/wjgpt.v6.i4.253]
Corresponding Author of This Article
Patrick Pessaux, MD, PhD, Professor, Head of the Hepato-Biliary and Pancreatic Surgical Unit, Institut Hospitalo-Universitaire de Strasbourg, Nouvel Hopital Civil, Hôpitaux Universitaire de Strasbourg, 1 place de l’Hôpital, 67091 Strasbourg, France. patrick.pessaux@chru-strasbourg.fr
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pharmacol Ther. Nov 6, 2015; 6(4): 253-256 Published online Nov 6, 2015. doi: 10.4292/wjgpt.v6.i4.253
Preoperative detection of intrahepatic venovenous shunt treated by microwave precoagulation during right hepatectomy
Jean-Baptiste Delhorme, Riccardo Méméo, Jacques Marescaux, Patrick Pessaux
Jean-Baptiste Delhorme, Riccardo Méméo, Jacques Marescaux, Patrick Pessaux, Institut Hospitalo-Universitaire de Strasbourg, Nouvel Hopital Civil, Hôpitaux Universitaire de Strasbourg, 67091 Strasbourg, France
Author contributions: All authors contributed to the acquisition of the data, writing and revision of the manuscript.
Supported by Institut Hospitalo-Universitaire de Strasbourg (IHU MixSurg), Strasbourg, France.
Institutional review board statement: This case report was exempt from institutional review board standards of University of Strasbourg.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: The authors have no conflicts of interest or financial ties to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Patrick Pessaux, MD, PhD, Professor, Head of the Hepato-Biliary and Pancreatic Surgical Unit, Institut Hospitalo-Universitaire de Strasbourg, Nouvel Hopital Civil, Hôpitaux Universitaire de Strasbourg, 1 place de l’Hôpital, 67091 Strasbourg, France. patrick.pessaux@chru-strasbourg.fr
Telephone: +33-3-69550552 Fax: +33-3-69551745
Received: May 12, 2015 Peer-review started: May 12, 2015 First decision: August 19, 2015 Revised: September 11, 2015 Accepted: October 12, 2015 Article in press: October 13, 2015 Published online: November 6, 2015 Processing time: 184 Days and 19.2 Hours
Abstract
A 53-year-old woman underwent a 2-stage right hepatectomy for bilobar metastasis of an ileal neuroendocrine carcinoma. Preoperative three-dimensional computed tomography reconstruction helped to diagnose an intrahepatic venovenous shunts from the right and middle hepatic veins to the left hepatic vein, which could cause a intraoperative bleeding. Hemostasis was performed by means of precoagulation with microwave-assisted coagulation.
Core tip: Detection of anomalies in hepatic vascularization before liver surgery is crucial in order to prevent intraoperative difficulties such as massive bleeding, which needs to be controlled. Surgical planning is now well-known as a major step in liver surgery. From a general standpoint, three-dimensional computed tomography (3D-CT) is not used to this purpose but can be very useful to identify vascular structures. We report a case where intrahepatic venovenous shunts were preoperatively diagnosed by means of 3D-CT reconstruction and were managed with precoagulation microwave-assisted coagulation.
