Polycystic diseaseに合併した胆管細胞癌の1切除例 [in Japanese] CASE OF CHOLANGIOCELLULAR CARCINOMA WITH POLYCYSTIC KIDNEY AND LIVER DISEASE TREATED BY RESECTION [in Japanese]
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症例は閉塞性黄疸を主訴とした63歳の男性.画像診断上,肝門部腫瘤と肝・腎・膵に多発性嚢胞がみられ, polycystic diseaseを併存した胆管細胞癌と診断された.平成3年7月17日,右肝動脈血行再建を伴った拡大肝左葉切除術を施行.術12日後より発熱,白血球増多を認め肝膿瘍を疑ったが多発性肝嚢胞併存のため診断に難渋した.その際,画像の経時的比較が肝嚢胞と肝膿瘍の鑑別診断に有用であった.なお, polycystic diseaseに併存した胆管細胞癌切除例の報告は検索した限り3例のみであり,極めて稀である.
We have treated a patient with polycystic kidney and liver disease with a coexisting cholangiocellular carcinoma surgically. Such treatment has not been reported in Japan so far, to the best of our knowledge. A 63-year-old man was admitted to the hospital because of obstructive jaundice. Imaging methods visualized a tumor of the porta hepatis and multiple cysts of the liver, kidney, and pancreas. The patient was diagnosed as having a cholangiocellular carcinoma with polycystic disease. Extended left lobectomy of the liver with reconstruction of the right hepatic artery and right hepaticojejunostomy was carried out. On and after 12th postoperative day, the patient had a fever and leukocytosis. A liver abscess was suspected, but we had difficulty in diagnosis, because the multiple liver cysts coexisted. Computed tomography done some days apart showed that the abscess changed while the cysts did not show any changes. If a patient with polycystic kidney and liver disease is treated by a surgical method that may increase a risk of liver abscesses, computed tomography should be done several times postoperatively to check the occurrence of this complication.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 56(6), 1200-1204, 1995-06-25
Japan Surgical Association