Communicating Veins Between Adjacent Hepatic Veins: an Intra-operative Ultrasound Study

Study Overview
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Brief Summary
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The search for communicating veins (CVs) between adjacent hepatic veins (HVs) has drawn its rationale from living donor liver transplantation (LDLT). Parenchymal sparing procedures although HVs are resected suggest that probably their presence is underestimated. Taking profit from new improvements in ultrasound technology the investigators aim to better estimate the rate of CVs in a consecutive series of patients in whom resection of one HV at caval confluence is needed.

Detailed Description
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The search for communicating veins (CVs) between adjacent hepatic veins (HVs) has drawn its rationale from the need of reducing the risk of incomplete blood outflow in the medial portion of the hemiliver without the middle hepatic vein (MHV) in living donor liver transplantation (LDLT). However, only 24% of patients seems having CVs based on the findings of color-Doppler intraoperative ultrasound (CD-IOUS) exploration. On the other hand the safety of parenchymal sparing procedure despite HV resection let suppose that CVs are probably more frequent than expected. Certainly, better in vivo knowledge of the rate of CVs and their direct detection would consolidate and probably further expand parenchymal sparing techniques. Taking profit from new advancements in ultrasound technology we have carried out the present study with the aim of better estimating the rate of CVs in a consecutive series of patients in whom resection of one HV at caval confluence was needed.

Official Title
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Communicating Veins Between Adjacent Hepatic Veins: Rare, Exceptional or Frequent? An Intra-operative Ultrasound Study

Conditions
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Liver Tumors

Intervention / Treatment
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* Procedure: Ultrasound guided liver resection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients suitable for being enrolled in the present study were those carriers of primary or metastatic tumour with direct contact or invasion of one HV at the caval confluence. Exclusion Criteria: N/A
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| caval confluence HV involvement<br>Patients carriers of primary or metastatic tumour with direct contact or invasion of one HV at the caval confluence. | Procedure: Ultrasound guided liver resection<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First outcome was the rate of CVs detectable with e-flow IOUS along clamping of the HV for which resection could be needed. |  |  | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Secondary outcome was safety (morbidity, mortality, blood loss, blood transfusions) of the procedure. |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Communicating veins, hepatic venous anastomosis, intra-operative ultrasonography, hepatic resection, hepatic neoplasm, Primary and metastatic liver tumors