ACUTE BUDD-CHIARI SYNDROME FOLLOWING HEPA TECTOMY

The authors report about 2 cases of Budd-Chiari syndrome occuring duri ng the immediate postoperative period of extensive hepatectomy, after exeresis of a large biliary cyst (20 cm in diameter) through 6/7 secto riectomy and after exeresis of a large sarcomatous tumor preserving on ly sectors 2 and 3 of the liver using an <<ex-vivo/in-situ>> technique . These 2 cases lead to discuss the diagnosis, treatment and, most imp ortantly, the prevention of acute suprahepatic obstruction after exten sive right hepatectomy. Similar cases are reported in the literature a fter partial liver transplantation. Prevention basically consists in t ethering the remaining liver to prevent rotation around the vena cava or the remaining suprahepatic vein. The emptied subphrenic fossa may b e filled up using the omentum or the right flexure of the colon.