Published online Nov 6, 2015. doi: 10.4292/wjgpt.v6.i4.253
Peer-review started: May 12, 2015
First decision: August 19, 2015
Revised: September 11, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: November 6, 2015
A 53-year-old woman underwent a 2-stage right hepatectomy for bilobar metastasis of an ileal neuroendocrine carcinoma. Preoperative three-dimensional computed tomography reconstruction helped to diagnose an intrahepatic venovenous shunts from the right and middle hepatic veins to the left hepatic vein, which could cause a intraoperative bleeding. Hemostasis was performed by means of precoagulation with microwave-assisted coagulation.
Core tip: Detection of anomalies in hepatic vascularization before liver surgery is crucial in order to prevent intraoperative difficulties such as massive bleeding, which needs to be controlled. Surgical planning is now well-known as a major step in liver surgery. From a general standpoint, three-dimensional computed tomography (3D-CT) is not used to this purpose but can be very useful to identify vascular structures. We report a case where intrahepatic venovenous shunts were preoperatively diagnosed by means of 3D-CT reconstruction and were managed with precoagulation microwave-assisted coagulation.