Autologous peritoneo-fascial patch for portal vein and inferior vena cava reconstruction: a case report with video vignette

Venous reconstruction with an autologous peritoneo-fascial patch (APFP) is a valuable technique during hepatobiliary surgery that enables resection with clear margins with readily available autologous tissue. This report details a case of an extended right hepatectomy with segment 1 resection and venous reconstruction using an APFP in a 42-year-old male with an intrahepatic cholangiocarcinoma invading the portal vein (PV) and inferior vena cava (IVC). The surgical approach included resection of the PV and IVC, and type 2 reconstruction with an APFP harvested from the left hypochondrium. The patch was sutured with 4-0 polypropylene, maintaining venous calibre and patency. Figures and an illustrative video of the venous reconstruction are shown. Histopathology confirmed an R0 resection (ypT4N1). This case demonstrates the feasibility of using an APFP for venous reconstruction and highlights its potential for curative resection in advanced hepatobiliary oncologic surgery.