Two-Stage Hepatectomy for Cholangiocarcinoma Under Total Vascular Exclusion with Veno-venous ECMO Bypass and Controlled Closed-loop In Situ Hypothermic Oxygenated Perfusion of the Liver: The Hannover CLIP-Concept.

ABSTRACT:

Background

Total vascular exclusion (TVE) enables the resection of centrally located liver tumors but remains associated with considerable intra- and perioperative morbidity. We present the Hannover Modification of TVE, which combines veno-venous extracorporeal membrane oxygenation (vvECMO) and a closed-loop in situ hypothermic oxygenated perfusion (CLIP) of the liver using the Bridge-to-Life^® VitaSmart system for targeted parenchymal protection.

Methods

A 62-year-old woman with FGFR2-fused intrahepatic cholangiocarcinoma (iCCA) involving the hepatocaval confluence and all three hepatic veins, previously deemed unresectable, underwent partial ALPPS-preserving segment IVb. One week later, extended right trisectionectomy with reconstruction of the left hepatic vein

SUBMITTER: van Beekum CJ 

PROVIDER: S-EPMC12765754 | biostudies-literature | 2026 Feb

REPOSITORIES: biostudies-literature