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Anterior Approach Right Hepatectomy Combined With Inferior Vena Cava Thrombectomy Using Trans-Diaphragmatic Intrapericardium IVC Occlusion
Xiangcheng Li*, Chenyu Jiao, Ke Wang, Xiaofeng Wu, Sheng Han, Xuehao Wang
Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

We describe a safe technique of en bloc right hepatectomy and thrombectomy for HCC with intrathoracic thrombi in the inferior vena cava.
After anterior approach parenchyma transection, RHV and IVC exposed. the supradiaphragmatic IVC was encircled for control through diaphragmatic pericardial cavity. The IVC thrombus was excised en-bloc from the incised RHV with satisfactory visualization of the intraluminal space under total hepatic vascular exclusion.
There was no recurrence of HCC until the time of 10 months after surgery.
Surgical resection for HCC with IVC tumor thrombi using trans-diaphragmatic intrapericardium supradiaphragmatic IVC occlusion can be safely performed.

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