한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)
- 제12권3호
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- Pages.214-221
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- 2008
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- 2508-5778(pISSN)
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- 2508-5859(eISSN)
상간하대정맥부터 총장골정맥분지까지 연장된 하대정맥 평활근육종의 체외절제 후 인공 하대정맥 재건 및 자가 간이식
Replacement of the Inferior Vena Cava and Hepatic Auto-Transplantation after Ex Situ Excision of a Leiomyosarcoma Extending from the Bifurcation of the Common Iliac Vein to the Suprahepatic Vena Cava
- 문덕복 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 이승규 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 김기훈 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 안철수 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 하태용 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 송기원 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 정동환 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 유제호 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 김관우 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 고경훈 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과) ;
- 최남규 (울산대학교 의과대학 서울아산병원 간담도 및 간이식외과)
- Moon, Deok-Bog (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Lee, Sung-Gyu (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Kim, Ki-Hun (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Ahn, Chul-Soo (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Ha, Tae-Yong (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Song, Gi-Won (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- , (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Ryu, Je-Ho (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Kim, Kwan-Woo (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Ko, Kyoung-Hoon (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine) ;
- Choi, Nam-Kyu (Hepato-Biliary Surgery and Liver Transplantation, Asan Medical Center, University of Ulsan College of Medicine)
- 발행 : 2008.09.30
초록
Ex situ resection and hepatic auto-transplantation as devised by Pichlmayr may be an answer for a lesion that has close proximity to or has invade the major hepatic veins. We report here on a 31-year-old female patient with a leiomyosarcoma extending from the suprahepatic vena cava to the bifurcation of the common iliac vein, and this tumor was deemed not accessible by the conventional in situ surgical techniques. The liver and retrohepatic inferior vena cava was removed en bloc and taken to the back-table where the neoplasm invading the cava wall was removed together with the inferior vena cava. The inferior vena cava was then replaced by a 26- mm Dacron graft proximally and a 20-mm ringed polytetrafluoroethylene (PTFE) graft distally, and the outflows of the liver was reconstructed to a single opening with using longitudinally-opened autogenous great saphenous vein fencing. The liver was then autotransplanted by the Piggyback technique. Both renal veins were not reconstructed because both gonadal veins were preserved during the operation. The postoperative course was uneventful and the patient is in good health until now.
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