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Salvage of a Right-extended Split Liver Graft Using Ex Situ Normothermic Machine Perfusion-A New Therapeutic Horizon.
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In situ split plus portal vein ligation (ISLT) - a salvage procedure following inefficient portal vein embolization to gain adequate future liver remnant volume prior to extended liver resection.
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Article Synopsis
- Right extended liver resections often need sufficient hypertrophy in segments II and III, but portal venous embolization (PVE) sometimes fails to achieve this, leading to the introduction of an in situ split dissection technique combined with portal disruption for better liver conditioning.* -
- In a study involving eight patients who underwent this in situ split dissection (ISLT) after unsuccessful PVE, their liver volume and surgical outcomes were compared to patients who had successful PVE before extended surgeries.* -
- Results indicated that while one patient faced intraoperative mortality, the remaining patients had a survival rate similar to those who underwent extended surgeries after successful PVE, suggesting ISLT is a viable option when PVE is insufficient.*