Top

Published in:

01-06-2016 | Original Article

Usefulness of a recanalized umbilical vein for vascular reconstruction in pediatric hepatic surgery

Authors: Masato Shinkai, Kyoko Mochizuki, Norihiko Kitagawa, Hiroshi Take, Hidehito Usui, Kaori Nakamura Yamoto, Shogo Fujita, Youkatsu Ohhama

Published in: Pediatric Surgery International | Issue 6/2016

Abstract

Purpose

Pediatric surgeons currently engage in various abdominal vascular surgeries, which sometimes require vascular conduits or grafts. Herein, we report our experience with patients undergoing vascular reconstruction using a recanalized umbilical vein (rUV) and their long-term outcome.

Method

Five patients with extrahepatic portal vein obstruction (EHPVO) underwent mesenterico-/porto-left portal vein (PV) bypass surgery using a short rUV conduit with an interposition vein graft. A sixth neonate with a huge hepatic tumor underwent PV reconstruction with anastomosis of rUV to the proximal PV stump following right hepatectomy with partial PV resection. A seventh patient underwent living donor liver transplantation for recurrent hepatoblastoma. The hepatic inferior vena cava (IVC) was resected because of tumor involvement and reconstructed by transposition of the infrahepatic IVC and interposition of rUV obtained from the donor liver graft.

Results

Sufficient flow through rUV was achieved and maintained in all patients without any complications during follow-up (0.7–6.9 years). Esophageal varices, splenomegaly, and other laboratory test abnormalities because of portal hypertension disappeared after surgery in patients with EHPVO.

Conclusion

Our experience confirmed the usefulness and long-term patency of rUV as an entry to the intrahepatic PV and as a free vascular graft to reconstruct PV or IVC.

Shinkai M, Ohhama Y, Honda S et al (2011) Recanalized umbilical vein as a conduit for mesenterico/porto-Rex bypass for patients with extrahepatic portal vein obstruction. Pediatr Surg Int 27:315–319CrossRefPubMed

Johnson WC, Lee KK (2000) A comparative evaluation of polytetrafluoroethylene, umbilical vein, and saphenous vein bypass grafts for femoral-popliteal above-knee revascularization: a prospective randomized Department of Veterans Affairs cooperative study. J Vasc Surg 32:268–277CrossRefPubMed

Nakao A, Nanami T, Harada A et al (1990) Portal vein resection with a new antithrombogenic catheter. Surgery 108:913–918PubMed

Yamanaka N, Yasui C, Yamanaka J et al (2000) Recycled use of reopened umbilical vein for venous reconstruction in hepatopancreatobiliary surgery. J Am Coll Surg 190:497–501CrossRefPubMed

Soejima Y, Shimada M, Suehiro T et al (2006) Reconstruction of the middle hepatic vein tributaries using the recipient’s recanalized umbilical vein in right-lobe living-donor liver transplantation. Surgery 139:442–445CrossRefPubMed

Rochon C, Sheiner PA, Sharma J et al (2013) The utility of recanalized umbilical vein graft to the hepatico-pancreato-biliary surgeon. Surg Innov 20:126–133CrossRefPubMed

di Francesco F, Grimaldi C, de Goyet JDV et al (2014) Meso-Rex bypass—a procedure to cure prehepatic portal vein hypertension: the insight and the inside. J Am Coll Surg 218:e23–e36CrossRefPubMed

Kaneko Y, Yamaguchi A, Isogai M et al (2000) Hepatic vein reconstruction by external iliac vein graft using vascular clips. World J Surg 24:377–382CrossRef

Okano K, Oshima M, Suzuki Y (2012) Hepatic venous outflow reconstruction using an external iliac vein graft for hepatic malignancies. J Hepatobiliary Pancreat Sci 19:85–90CrossRefPubMed

10.

Fuchs J, Warmann S, Kardorff R et al (2003) Mesenterico-left portal vein bypass in children with congenital extrahepatic portal vein thrombosis: a unique curative approach. J Pediatr Gastroenterol Nutr 36:213–216CrossRefPubMed

11.

Czauderna P, Lopez-Terrada D, Hiyama E et al (2014) Hepatoblastoma state of the art: pathology, genetics, risk stratification, and chemotherapy. Curr Opin Pediatr 26:19–28CrossRefPubMed

12.

Yamamoto Y, Terajima H, Ishikawa Y et al (2001) In situ pedicle resection in left trisegmentectomy of the liver combined with reconstruction of the right hepatic vein to an inferior vena caval segment transpositioned from the infrahepatic portion. J Am Coll Surg 192:137–141CrossRefPubMed

13.

Quinones-Baldrich W, Alktaifi A, Eilber F et al (2012) Inferior vena cava resection and reconstruction for retroperitoneal tumor excision. J Vasc Surg 55:1386–1393CrossRefPubMed

Title: Usefulness of a recanalized umbilical vein for vascular reconstruction in pediatric hepatic surgery
Authors: Masato Shinkai
Kyoko Mochizuki
Norihiko Kitagawa
Hiroshi Take
Hidehito Usui
Kaori Nakamura Yamoto
Shogo Fujita
Youkatsu Ohhama
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Surgery International / Issue 6/2016
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-016-3893-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Usefulness of a recanalized umbilical vein for vascular reconstruction in pediatric hepatic surgery

Abstract

Purpose

Method

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2016

Pyeloplasty in children: perioperative results and long-term outcomes of robotic-assisted laparoscopic surgery compared to open surgery

Oesophageal atresia is correctable and survivable in infants less than 1 kg

In vivo regeneration of bladder muscular wall using decellularized colon matrix: an experimental study

Patients exposed to diagnostic head and neck radiation for the management of shunted hydrocephalus have a significant risk of developing thyroid nodules

Predicting pseudocyst formation following pancreatic trauma in pediatric patients

Spontaneous gallbladder perforation in a child secondary to a gallbladder cyst: a rare presentation and review of literature