Vascular Isolation in Treatment of Juxtahepatic Venous Injuries

Abstract

Juxtahepatic venous injuries have usually been lethal. Isolation of such a venous injury from hepatic venous drainage and from the systemic venous circulation should enhance the likelihood of success in treatment. Such isolation may be achieved by occlusion of the vena cava above and below the liver or by insertion of a vena caval shunt. In either instance there must be simultaneous occlusion of afferent blood flow to the liver. One or the other of these methods were employed in six patients with juxtahepatic venous injuries, three of whom were long-term survivors. Experimental studies designed to determine the most desirable way to achieve vascular isolation of juxtahepatic venous injuries suggest that the use of multiple occlusive clamps is a simpler and more direct method to achieve vascular isolation than is the insertion of a vena caval shunt.