Tomohide Takahashi

Radical surgery for Budd-Chiari syndrome. Direct Excision and repair for obstruction of the Vena Cava (Budd-Chiari syndrome) under hepatic vascular exclusion using a centrifugal pump

OBJECTIVE To attempt to reduce the incidence of hepatic and cardiac failure after radical surgery for the Budd-Chiari syndrome. DESIGN Retrospective case study. SETTING University hospital, Japan SUBJECTS Three patients with obstruction of the vena cava (Budd-Chiari syndrome) by a thick membrane, thrombus, and a long stenosis, respectively. INTERVENTION Direct excision and repair by patch dilatation under hepatic vascular exclusion using a Biomedicus centrifugal pump. RESULTS Hepatic vascular exclusion provides good visibility and enables accurate assessment of the obstruction, proper treatment, and relatively little blood loss. There were no complications, particularly liver failure or heart failure, and the inferior vena cava stayed patent in all cases. Liver function was improved in all three patients. CONCLUSION This technique is safe and reliable for removal of obstruction of the inferior vena cava (Budd-Chiari syndrome).

Laparoscopic repair of acute small bowel obstruction due to left paraduodenal hernia: A case report

Highlights • Paraduodenal hernia is a rare disease but the most common internal hernia.• Computed tomography is the standard for a correct diagnosis in left paraduodenal hernia.• Laparoscopic repair of paraduodenal hernia is feasible and effective because of its minimal invasiveness and aesthetic advantage.