BACKGROUND/AIMS: Surgery for advanced @entity157 with inferior vena cava or right atrium extension represents challenging procedures for hepatobiliary surgeons. Regardless of the surgical approach chosen, the liver parenchyma inevitably has to suffer from @entity63 during the total hepatic vascular exclusion period. METHODOLOGY: We report our novel technique for resection of a huge @entity157 extending to the right atrium. During the total hepatic vascular exclusion period, in-situ cold perfusion of the liver was performed in order to minimize the ischemic insults. RESULTS: The 53-year-old male @entity1 with @entity6194 was diagnosed to have a huge @entity157 , besides which the @entity5 had invaded the right hepatic vein and right atrium. With the help of @entity358 and in-situ cold perfusion of the liver, the @entity5 was removed en-bloc. The operating time was 458 minutes. The cold @entity63 time of the liver was 53 minutes 30 seconds. The @entity358 time was 61 minutes. The estimated @entity190 was about 7000 ml. The @entity1 was discharged under stable condition on postoperative day 35. CONCLUSIONS: In selected @entity1 , when the expected @entity5 resection time is long, the in-situ cold perfusion of the liver could be considered an option.

A novel technique for resection of huge XXXX extending to the right atrium: in-situ cold perfusion of liver.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity6194 :: ('MESH:D019694', 'Disease') :: ['chronic hepatitis B'] @entity358 :: ('MESH:D008171', 'Disease') :: ['cardio-pulmonary bypass'] @entity157 :: ('MESH:D006528', 'Disease') :: ['right lobe hepatocellular carcinoma', 'hepatocellular carcinoma']
@entity157 :: (MESH:D006528,Disease) :: ['right lobe hepatocellular carcinoma']
