Surgical management of right hepatectomy after coronary artery bypass grafting using the right gastroepiploic artery: a case report and literature review.
World J Surg Oncol
; 22(1): 119, 2024 May 03.
Article
in En
| MEDLINE
| ID: mdl-38702732
ABSTRACT
BACKGROUND:
Coronary artery bypass grafting (CABG) using the right gastroepiploic artery (RGEA) is a well-established, safe procedure. However, problems with RGEA grafts in subsequent abdominal surgeries can lead to fatal complications. This report presents the first case of right hepatectomy for hepatocellular carcinoma after CABG using the RGEA. CASE PRESENTATION We describe a case in which a right hepatectomy for an 81-year-old male patient with hepatocellular carcinoma was safely performed after CABG using a RGEA graft. Preoperatively, three-dimensional computed tomography (3D- CT) images were constructed to confirm the run of the RGEA graft. The operation was conducted with the standby of a cardiovascular surgeon if there was a problem with the RGEA graft. The RGEA graft had formed adhesions with the hepatic falciform ligament, necessitating meticulous dissection. After the right hepatectomy, the left hepatic lobe descended into the vacated space, exerting traction on the RGEA. However, this traction was mitigated by suturing the hepatic falciform ligament to the abdominal wall, ensuring stability of the RGEA. There were no intraoperative or postoperative complications.CONCLUSION:
It is crucial to confirm the functionality and anatomy of the RGEA graft preoperatively, handle it gently intraoperatively, and collaborate with cardiovascular surgeons.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Coronary Artery Bypass
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Carcinoma, Hepatocellular
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Gastroepiploic Artery
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Hepatectomy
/
Liver Neoplasms
Limits:
Aged80
/
Humans
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Male
Language:
En
Journal:
World J Surg Oncol
Year:
2024
Type:
Article
Affiliation country:
Japan