Resection of a locally advanced hilar tumor and the hepatic artery after stepwise hepatic arterial embolization: a case report.
We herein report a case of a hilar tumor with extensive invasion to the proper hepatic artery, which was successfully treated with a radical resection in a 57-year-old female patient after a stepwise hepatic arterial embolization. She underwent right colectomy and partial hepatectomy for advanced colon cancer two years ago and radiofrequency ablation therapy for a liver metastasis one year ago, respectively. A recurrent tumor was noted around the proper hepatic artery with invasion to the left hepatic duct and right hepatic artery 7 mo previously. We planned a radical resection for the patient 5 mo after the absence of tumor progression was confirmed while he was undergoing chemotherapy. To avoid surgery-related liver failure, we tried to promote the formation of collateral hepatic arteries after stepwise arterial embolization of the posterior and anterior hepatic arteries two weeks apart. Finally, the proper hepatic artery was occluded after formation of collateral flow from the inferior phrenic and superior mesenteric arteries was confirmed. One month later, a left hepatectomy with hepatic arterial resection was successfully performed without any major complications.
Miura
Takuya
T
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan.
Hakamada
Kenichi
K
Ohata
Takashi
T
Narumi
Shunji
S
Toyoki
Yoshikazu
Y
Nara
Masaki
M
Ishido
Keinosuke
K
Ohashi
Motonari
M
Akasaka
Harue
H
Jin
Hiroyuki
H
Kubo
Norihito
N
Ono
Shuichi
S
Kijima
Hiroshi
H
Sasaki
Mutsuo
M
D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery* / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery / Q000628:therapy