Adhesiolysis for Liver Resection in a Patient with a Reconstructed Stomach Tube after Esophagectomy
Adhesiolysis for Liver Resection in a Patient with a Reconstructed Stomach Tube after Esophagectomy作者机构：Department of Surgery Fujisaki Hospital Tokyo Japan Division of Digestive Surgery Nihon University School of Medicine Tokyo Japan Department of Surgery Nippon Dental University Tokyo Japan
出 版 物：《Journal of Cancer Therapy》 (癌症治疗（英文）)
年 卷 期：2020年第11卷第6期
页 面：371-376页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
主 题：Detachment of Adhesions Liver Resection Reconstructed Stomach Tube
摘 要：To our knowledge this is the first report to provide a detailed description of surgical procedure for adhesiolysis and hepatectomy in patients who have undergone esophagectomy and reconstruction. We performed a hepatic resection of the left medial segment in a patient with a reconstructed stomach tube after esophagectomy for the esophageal carcinoma. The reconstructed stomach tube overlapped with the left medial segment of the liver and the hepatoduodenal ligament and was extensively and strongly adhered to them. It is important for clinicians to know how to perform the detachment procedure successfully in order to secure a surgical field for liver resection without damaging the fragile reconstructed gastric tube. In order to avoid vascular injury of the stomach tube, it was decided that detachment around the hepatoduodenal ligament preceded detachment of the stomach tube from the liver. After complete separation of the hepatoduodenal ligament from the stomach tube, the hepatoduodenal ligament was encircled with tape. Subsequently, adhesiolysis was performed between the stomach tube and the liver. Finally, parenchymal transection was performed using the intermittent hepatic inflow occlusion and crush clamping techniques to dissect the parenchyma. The patient was discharged two weeks after surgery without complication.
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