Late-onset venous stenosis after hepatic vein reconstruction may signal tumor recurrence, impacting how you monitor and treat patients.

• In a study of 72 reconstructed veins, 19 developed stenosis: 14 due to technical issues, and 5 linked to tumor recurrence.
• Technical stenoses occurred within 6 months, whereas late stenoses were associated with tumor recurrence detected years later.

Surgeons should maintain a high index of suspicion for recurrent disease in patients with late venous stenosis.

• Redo reconstruction is viable, as demonstrated in a case involving a 49-year-old woman with unresectable rectal cancer.