若年者巨大肝癌の1例  [in Japanese] YOUNG ON-SET GIANT HEPATOMA : REPORT OF A CASE  [in Japanese]

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若年者巨大肝癌の1切除例を経験した.患者は24歳男性でHBe抗原陰性, HBe抗体陽性であった.肝癌は肝右葉の大部分及び一部肝左葉内側区域にも及んでいた.腫瘍が巨大なことより,右第7肋間開胸,開腹アプローチによる肝右三区域切除術を施行した.術後2日目より肝切除断端付近のドレーンから1日約300ml~400mlの胆汁漏出が持続し,それに引き続いて右横隔膜下肝切除断端に膿瘍を形成した.術後24日目にUS下ドレナージ術を施行.以後発熱もおさまり術後57日目に軽快退院となった.しかし術後6カ月で残肝再発をきたし計3回のTAEが施行された.

We experienced a resected case of young on-set hepatoma. The patient was a 24-year-old man. HBe antigen was negative and HBe antibody was positive. The hepatoma extended almost entire the right lobe and a part of medial segment of the left lobe of the liver. Since the tumor was so huge, right triseg-mentectomy under the right side 7th intercostal thoracotomy and laparotomy was performed.<br> On and after the second postoperative day about 300-400ml of bile juice defluxtion daily lasted from a drain near the stump after hepatectomy, followed by abscess formation in the stump under the right diaphragm. On the 24th postoperative day ultrasonography-guided drainage operation was carried out. Thereafter fever fell to the normal range. The patient was discharged from the hospital on the 57th day after the operation. But 3 times of TAE were added for a recurrence of hepatoma occurred 6 months after the hepatectomy.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 56(10), 2163-2168, 1995-10-25

    Japan Surgical Association

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