Surgical treatment for common hepatic aneurysm. Original one-step technique

Author:

Amato Bruno1,Patrone Renato1,Quarto Gennaro1,Compagna Rita1,Cirocchi Roberto2,Popivanov Georgi3,Granata Vincenza4,Belli Andrea5,Izzo Francesco5

Affiliation:

1. Department of Clinical Medicine and Surgery, University of Naples Federico II, Medical School, Naples, Italy

2. Department of Surgical Sciences, University of Perugia, Perugia, Italy

3. Department of Surgery, Military Medical Academy, Sofia, Bulgaria

4. Department of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione G. Pascale – Napoli”, Naples, Italy

5. Department of Surgical Oncology, Hepatobiliary Unit, “Istituto Nazionale Tumori IRCCS Fondazione G. Pascale – Napoli”, Naples, Italy

Abstract

AbstractIntroductionHepatic artery aneurysms are rare, and their treatment represents a challenge for the surgeons.Materials and methodsA new technique is presented for common hepatic artery (CHA) aneurysm: it requires minimal vascular surgical dissection and only one linear vascular stapler is applied at the bottom of aneurysm. Aneurysm exclusion is easily obtained, which allowed retrograde thrombosis. Liver blood supply is ensured to the right and left hepatic artery, through the gastroduodenal artery, and can be previously monitored, with temporary clamping of the section area, by visual control, enzyme evaluation and intraoperative ultrasound examination. We reported an open surgical treatment, with simultaneous removal of hepatic and adrenal metastases, secondary to colon cancer.ResultsThe duration of vascular surgery was 30 min and did not involve complications. Postoperative controls confirmed the efficacy of the procedure.DiscussionThis original technique can be added to the various open and endovascular techniques so far described for the treatment of a CHA aneurysm. It is advisable as open surgery, mostly in case of associated pathologies.ConclusionsThe authors believe that this “one shot” technique by vascular staple of the distal part of CHA is minimally invasive and effective to obtain the exclusion of the aneurysm.

Publisher

Walter de Gruyter GmbH

Subject

General Medicine

Reference64 articles.

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5. Management of complications of first instance of hepatic trauma in a liver surgery unit: portal vein ligation as a conservative therapeutic strategy;Open Med (Wars),2019 May 21

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