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Vol. 100. Issue 7.
Pages 437-439 (July 2022)
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Vol. 100. Issue 7.
Pages 437-439 (July 2022)
Innovation in surgical technique
Treatment of acute intraoperative Budd-Chiari syndrome by placement of silicone prosthesis
Tratamiento del síndrome de Budd-Chiari agudo intraoperatorio mediante colocación de prótesis de silicona
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Irene Mirón Fernández
Corresponding author
irenemironfernandez@gmail.com

Corresponding author.
, Belinda Sánchez Pérez, José Antonio Pérez Daga, Julio Santoyo Santoyo
Servicio de Cirugía General y del Aparato Digestivo y Trasplantes, Complejo Regional Universitario de Málaga, Spain
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Abstract

Complete liver mobilization for major resections sometimes causes liver tilting due to the release of the suspensory elements of the liver. Rarely this may take to a liver abnormal position with acute obstruction to venous flow at the suprahepatic level (Budd-Chiari syndrome). To avoid this complication, techniques such as post-operative stent implantation have been described. The case of a patient who underwent a complete mobilization of the liver for resection of the inferior venous cava and a right renal tumor, was reported. After that, an acute Budd-Chiari Syndrome was observed caused of the liver malposition, which was solved with the placement of two silicone prostheses in the liver cell.

Keywords:
Liver
Malposition
Prosthesis
Resumen

La movilización hepática completa para resecciones mayores provoca, en ocasiones, basculación del hígado secundaria a la liberación de sus elementos suspensorios. Esto puede ocasionar una malposición hepática con obstrucción aguda al flujo venoso a nivel de las suprahepáticas (síndrome de Budd-Chiari). Para salvar esta complicación se han descrito técnicas como colocación de sondas de Foley, balón Sengstaken-Blakemore o implantación de endoprótesis vasculares en el postoperatorio. Aquí presentamos el caso de un paciente al que se le realizó una movilización completa para resección de un tumor renal derecho y resección de vena cava inferior por trombosis de ésta hasta entrada de las venas suprahepáticas. Durante el proceso se produjo un Budd-Chiari agudo por malposición del hígado que fue resuelto con la colocación de dos prótesis de silicona en la celda hepática.

Palabras clave:
Hígado
Malposición
Prótesis

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