Reconstruction of portal vein using a hepatic vein patch graft after combined hepatectomy and portal vein resection

BACKGROUND: Surgical resection is the only treatment modality that ensures complete tumor removal in patients with liver tumors involving a major portal vein branch or its bifurcation. Restoration of good portal blood flow is essential for recovery in the early postoperative period and for long-term survival. However, such extended resections often result in large defects at the bifurcation of the portal vein that are not amenable to suturing or end-to-end anastomosis. METHODS: A patch graft technique is very useful for reconstruction of long and elongated defects when other methods are not technically appropriate. We describe a simple technique for reconstructing the portal vein using a patch graft obtained from the hepatic vein stump of the resected specimen. CONCLUSIONS: This technique permits surgeons to reconstruct the portal vein without any need for harvesting another vein and with no need for an additional incision.