Safety and efficacy of hepatic vein reconstruction for colorectal liver metastases

BackgroundColorectal liver metastases with hepatic vein (HV) involvement may require combined resection of the liver and HV. However, the short- and long-term outcomes of such a procedure remain unclear.MethodsWe reviewed 16 cases of liver resection with major HV resection and reconstruction.ResultsThe patients had a median age of 58.5 years (range, 50–74 y). In total, 18 HVs were reconstructed using a customized great saphenous vein graft (n = 10), direct anastomosis (n = 1), external iliac vein (n = 2), portal vein (n = 1), umbilical vein patch graft (n = 3), or ovarian vein patch graft (n = 1). There was no hospital mortality, and the morbidity rate was 50%. With a median follow-up period of 30 months (range, 4–89 mo), 3 patients died of tumor recurrence and 13 were alive with (n = 6) and without (n = 7) disease. Cumulative 1-, 3-, and 5-year survival rates were 93%, 76%, and 76%, respectively.ConclusionsHV resection and reconstruction combined with liver resection can be performed safely with reasonable long-term results.