Anatomical liver segmentectomy 2 for combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in segment 2 portal branch

World Journal of Surgical Oncology

Technical Innovations

Takeshi Mazaki¹  Takuma Kobayashi²  Masumi Nishimura²  Atsushi Toma²  Kenji Nakamura²  Hiromichi Ishii²  Michihiro Kudou²  Tsuyoshi Itoh² 

[1] Division of Pathology, Kyoto Prefectural Yosanoumi Hospital, 481 Otokoyama, Yosano-cho, Yosa-gun, 629-2261, Kyoto, Japan;Division of Surgery, Kyoto Prefectural Yosanoumi Hospital, 481 Otokoyama, Yosano-cho, Yosa-gun, 629-2261, Kyoto, Japan;

关键词: anatomical segmentectomy 2;    portal vein tumor thrombus;    combined hepatocellular carcinoma and cholangiocarcinoma;    modified selective hepatic vascular exclusion;   

DOI  :  10.1186/1477-7819-10-22

 received in 2011-09-09, accepted in 2012-01-25,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundHepatic resection is the only effective treatment for combined hepatocellular carcinoma and cholangiocarcinoma.Case presentationA 52-year-old man was preoperatively diagnosed with hepatocellular carcinoma in segment 2 with tumor thrombus in the segment 2 portal branch. Anatomical liver segmentectomy 2, including separation of the hepatic arteries, portal veins, and bile duct, enabled us to remove the tumor and portal thrombus completely. Modified selective hepatic vascular exclusion, which combines extrahepatic control of the left and middle hepatic veins with occlusion of left hemihepatic inflow, was used to reduce blood loss. A pathological examination revealed combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in the segment 2 portal branch. No postoperative liver failure occurred, and remnant liver function was adequate.ConclusionThe separation method of the hepatic arteries, portal veins, and bile duct is safe and feasible for a liver cancer patient with portal vein tumor thrombus. Modified selective hepatic vascular exclusion was useful to control bleeding during liver transection. Anatomical liver segmentectomy 2 using these procedures should be considered for a patient with a liver tumor located at segment 2 arising from a damaged liver.

【 授权许可】

CC BY   
© Ishii et al; licensee BioMed Central Ltd. 2012