A Case Report of Porto-umbilical Vein Anastomosis for Portal Vein Injury during Surgery

A case of porto-umbilical vein anastomosis for portal vein injury during surgery is reported. A 65-year-old man was admitted to our hospital because of a tumor of the liver. The tumor was diagnosed as hepatocellular carcinoma in the posterior segment of the right lobe of the liver, measuring 11 cm. On the portography, the posterior branch was ramified independently, then the anterior and left branches were bifurcated. Since the liver function was good, right hepatectomy was performed. During the operation, the portal trunk was mistaken as a posterior branch and divided. Portal blood flow was preserved only in the left caudate branch. Because direct anastomosis of the divided portal vein was impossible, the portal trunk and the recanalized umbilical vein were anastomosed. Postoperative angiography revealed patency of the porto-umbilical anastomosis. Porto-umbilical anastomosis for portal vein injury is an alternative when direct anastomosis of the divided portal vein is impossible.