Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5602
Peer-review started: May 24, 2023
First decision: June 19, 2023
Revised: July 1, 2023
Accepted: July 17, 2023
Article in press: July 17, 2023
Published online: August 16, 2023
Processing time: 83 Days and 13.7 Hours
Ex vivo liver resection and autotransplantation (ELRA) is an essential approach for treating patients with end-stage hepatic alveolar echinococcosis (AE), and its surgical indications involve severe invasion of important hepatic vessels, which makes in vivo resection impossible. Revascularization is a major step in the process of ELRA, which is extremely challenging when the invaded vessels have huge defects.
Herein, we have reported the case of a 26-year-old patient with hepatic AE in an autologous liver graft who underwent complex inferior vena cava (IVC) reconstruction using disease-free IVC, autologous portal vein fragments, and umbilical vein within the ligamentum teres hepatis. The patient showed good surgical recovery without vascular-related complications during the long-term follow-up.
We reviewed three studies that have reported complex revascularization of the IVC. This case report and systematic review showed that the use of autologous perihepatic vessels prevents donor-area trauma, immune rejection, and other adverse reactions. When the blood vessel is severely invaded and a single vascular material cannot repair and reconstruct the defect, ELRA may provide a safe and feasible surgical approach, which has good prospects for clinical application.
Core Tip:Ex vivo liver resection and autotransplantation (ELRA) is an essential approach to cure end-stage hepatic alveolar echinococcosis (AE). Revascularization is a central and challenging step in the process of ELRA when the invaded vessels have large defects. Here, we report the case of a 26-year-old patient with hepatic AE in an autologous liver graft who underwent complex inferior vena cava (IVC) reconstruction using disease-free IVC, autologous portal vein fragments and umbilical vein within the ligamentum teres hepatis and with good surgical recovery without vascular-related complications at long-term follow-up. This study demonstrate that the blood vessel is severely invaded and a single vascular material cannot repair and reconstruct the defect, this technique may provide a feasible surgical option for revascularization during ELRA and has good prospects for clinical application.