LAUSR

The retro-hepatic portion of the inferior vena cava (IVC) may be difficult to isolate in case of tumors involving the posterior segments of the liver and the caudate lobe. In such instances, major hepatic resections en bloc with the IVC may be required. Among the complex procedures applied to IVC and caudate lobe resections, even vascular exclusion of the liver and in situ/ex vivo procedures with a veno-venous bypass may be considered to guarantee splanchnic and systemic venous outflow during surgery. Despite the technical perfection of those techniques, for many patients, marginal liver function and the high risk of postoperative liver failure represent a significant limitation to major hepatectomies including IVC reconstruction.