A PATIENT WITH VP3 HEPATOCELLULAR CARCINOMA WHO UNDERWENT RADICAL TRISEGMENTECTOMY WITH PORTAL VEIN RECONSTRUCTION

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  • 腫瘍栓の門脈塞栓効果によって根治切除しえた肝細胞癌の1例

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Abstract

A 58-year-old man who was suffering from chronic hepatitis was pointed out having space occupied lesions in the liver on echogram of the adomen. There were three tumors in the segment 4, 5 and 6. The predictory liver function point advocated by Okamoto and his coworkers amounted to 52 points. Radical right trisegmentectomy seemed to be impossible because of the less of residual hepatic volume. After three times of trans-arterial embolization (TAE), however, tumor thrombus appeared from the main to first branch of the portal vein and it caused atrophic right lobe and compensative hypertrophic lateral segment. We thought that radical operation should be carried out, because the liver function point come up to 33 points. So 23 months after the diagnosis, radical operation with reconstruction of the portal vein was perfomed. Postoperative course was uneventful. The patient is doing well as of 3 years and 5 months after the operation. The reasons why the radical operation was able to be done were: 1) Three tumors multicentrically arised in the liver; 2) TAE performed three times for the tumors was effective; 3) Tumor thrombus from the main to first branch caused atrophic right lobe and compensative hypertrophic lateral segment; and 4) Tumor thrombus naturally necrosed.

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