Hepatic artery aneurysm resection and reconstruction

Resection of a hepatic artery aneurysm and reconstruction of the hepatic artery with a saphenous vein graft

 

00:17  SURGICAL PLANNING

02:03  EXPOSURE & MOBILIZATION

03:20  DISSECTION

05:01  BEGIN RECONSTRUCTION & RESECTION

09:23  COMPLETE RECONSTRUCTION & CLOSING

Case description
  • A 58 year old man presented with an intra-aneurysmal chronic thrombus of the hepatic artery distal to the LGA and splenic arteries and proximal to the GDA.
  • Risk of aneurysm rupture is significant and may result in death, so precautions are taken to control all major arterial branches before opening the aneurysm to resect the thrombus.
Surgical plan
  • The GDA and proximal CHA will be ligated but not divided.
  • Following clamping of the left and right hepatic arteries, the proper hepatic artery will be divided sharply with scissors.
  • A length of saphenous vein will be resected to use for a jump graft.
  • Aorta-to-graft anastomosis will be done using a double-armed suture. The graft will be parachuted into position and both lateral and medial walls reconstructed moving cephalad to caudad.
  • Graft-to-hepatic artery anastomosis will also be done using a double-armed suture. The graft will be parachuted into position and both lateral and medial walls reconstructed moving cephalad to caudad.
CT scans (pre-op)

Click to turn annotations on/off

CT scans (post-op)

Click to turn annotations on/off

RELATED CATEGORIES: HEPATO-PANCREATO-BILIARY | LIVER | VASCULAR 

SHARE THIS: