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

NCT ID: NCT00960609

Last Updated: 2009-08-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Study Classification

OBSERVATIONAL

Study Start Date

2008-01-31

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.

Conditions

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Liver Tumors

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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caval confluence HV involvement

Patients carriers of primary or metastatic tumour with direct contact or invasion of one HV at the caval confluence.

Ultrasound guided liver resection

Intervention Type PROCEDURE

Interventions

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Ultrasound guided liver resection

Intervention Type PROCEDURE

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
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Milan

OTHER

Sponsor Role lead

Responsible Party

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University of Milan, Istituto Clinico Humanitas IRCCS

Locations

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Istituto Clinico Humanitas, IRCCS

Rozzano, Milano, Italy

Site Status

Countries

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Italy

References

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Torzilli G, Procopio F, Botea F, Marconi M, Del Fabbro D, Donadon M, Palmisano A, Spinelli A, Montorsi M. One-stage ultrasonographically guided hepatectomy for multiple bilobar colorectal metastases: a feasible and effective alternative to the 2-stage approach. Surgery. 2009 Jul;146(1):60-71. doi: 10.1016/j.surg.2009.02.017.

Reference Type BACKGROUND
PMID: 19541011 (View on PubMed)

Torzilli G, Donadon M, Marconi M, Palmisano A, Del Fabbro D, Spinelli A, Botea F, Montorsi M. Hepatectomy for stage B and stage C hepatocellular carcinoma in the Barcelona Clinic Liver Cancer classification: results of a prospective analysis. Arch Surg. 2008 Nov;143(11):1082-90. doi: 10.1001/archsurg.143.11.1082.

Reference Type BACKGROUND
PMID: 19015467 (View on PubMed)

Torzilli G, Donadon M, Marconi M, Botea F, Palmisano A, Del Fabbro D, Procopio F, Montorsi M. Systematic extended right posterior sectionectomy: a safe and effective alternative to right hepatectomy. Ann Surg. 2008 Apr;247(4):603-11. doi: 10.1097/SLA.0b013e31816387d7.

Reference Type BACKGROUND
PMID: 18362622 (View on PubMed)

Torzilli G, Donadon M, Palmisano A, Del Fabbro D, Spinelli A, Makuuchi M, Montorsi M. Back-flow bleeding control during resection of right-sided liver tumors by means of ultrasound-guided finger compression of the right hepatic vein at its caval confluence. Hepatogastroenterology. 2007 Jul-Aug;54(77):1364-7.

Reference Type BACKGROUND
PMID: 17708255 (View on PubMed)

Torzilli G, Montorsi M, Del Fabbro D, Palmisano A, Donadon M, Makuuchi M. Ultrasonographically guided surgical approach to liver tumours involving the hepatic veins close to the caval confluence. Br J Surg. 2006 Oct;93(10):1238-46. doi: 10.1002/bjs.5321.

Reference Type BACKGROUND
PMID: 16953487 (View on PubMed)

Sano K, Makuuchi M, Miki K, Maema A, Sugawara Y, Imamura H, Matsunami H, Takayama T. Evaluation of hepatic venous congestion: proposed indication criteria for hepatic vein reconstruction. Ann Surg. 2002 Aug;236(2):241-7. doi: 10.1097/00000658-200208000-00013.

Reference Type BACKGROUND
PMID: 12170030 (View on PubMed)

Other Identifiers

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CV-HV

Identifier Type: -

Identifier Source: org_study_id

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