[Intra-arterial and intraportal therapy combined with decollateralization in unresectable cholangiocellular carcinoma--a case report].
A 45-year-old man was referred to our hospital due to obstructive jaundice by intrahepatic cholangiocellular carcinoma. At laparotomy, he was assessed as unresectable because of multiple foci in both lobes. Therefore, two catheters connected to implantable access devices were placed in both the hepatic artery and the portal vein following decollateralization using silicone rubber sheeting, in addition to choledochectomy and choledocho-jejunostomy. After the surgical procedure, he underwent chemoembolization twice using Lipiodol, cisplatin, and Gelfoam, and two intraportal infusions of cisplatin at a dose of 50 mg. Moreover, a total dose of 4 g of 5-FU and 20 mg of MMC was administered through the arterial and portal catheters, respectively. Administration of G-CSF was remarkably effective for severe thrombocytopenia, and leukopenia resulted from this active chemotherapy. He is still alive 7 months after the surgical procedure with the regression of the lesions.
Wada
H
H
Dept. of Surgery, Center for Adult Diseases, Osaka.
Sasaki
Y
Y
Imaoka
S
S
Shibata
T
T
Nagano
H
H
Ishikawa
O
O
Ohigashi
H
H
Furukawa
H
H
Fukuda
I
I
Kabuto
T
T
D002759:Adenoma, Bile Duct / Q000098:blood supply / Q000188:drug therapy / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000098:blood supply / Q000188:drug therapy / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic / Q000098:blood supply / Q000601:surgery; D003097:Collateral Circulation; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage; D011169:Portal Vein; D019736:Prostheses and Implants; D012826:Silicone Elastomers
D008937:Mitomycins; D012826:Silicone Elastomers; D016685:Mitomycin; D005472:Fluorouracil