[Two cases of intrahepatic biloma during hepatic arterial infusion chemotherapy proved by CT-Scan].
Hepatic arterial infusion chemotherapy using 5-FU is effective for colorectal cancer, but there are increasing reports of complications, for example, liver abscess, bile duct necrosis and sclerosing cholangitis. We encountered two cases of liver cell necrosis around the Glisson's sheath which were discovered by CT-scan. At the first operation, liver metastasis was present and a resection of the main tumor and metastatic lesion was performed. Hepatic cannulation was done in one case at the same time as the operation, and another at a different time. The metastatic lesion was well controlled and the blood serum CEA was within normal limits. It was pointed out that the mechanism of the liver cell necrosis was due to ischemia or toxicity of the anticancer drug. In two cases, the destruction of the second or third branch of bile duct was remarkable, because of the high 5-FU levels in the proximal part of the liver cells. One mechanism involved the laminar flow of the artery. Percutaneous transhepatic drainage was effective for the biloma around the Glisson's sheath.
Dept. of Surgery, Tokyo Metropolitan Komagome Hospital.
F
F
Aoki
T
T
Mori
K
K
Takahashi
Y
Y
Moriyama
S
S
Tanaka
T
T
Takahashi
D000328:Adult; D001646:Bile; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D005472:Fluorouracil