title: Hemorrhage from varices in hepaticojejunostomy in the fifth and tenth year after surgery for hepatic hilar bile duct cancer: a case report.
abstract: We report a case of a 64-year-old female patient who underwent a right lobectomy of the liver (including total resection of the caudate lobe), dissection of the group 2 lymph nodes, left hepaticojejunostomy (Roux-en-Y fashion), and reconstruction of the portal vein (end-to-end anastomosis between the main portal vein and the left portal branch) for treatment of hepatic hilar bile duct cancer in 1996. In 2001, the anastomotic site of the hepaticojejunostomy was dissected and re-anastomosed due to gastrointestinal bleeding caused by variceal rupture in the jejunal loop. In 2006, splenectomy was performed for recurrence of gastrointestinal bleeding due to another variceal rupture in the jejunal loop. Portal venography performed perioperatively showed a decrease in portal blood flow into the liver via the jejunal varices and an increase in portal blood flow into the liver via the left gastric vein. She had two jejunal variceal ruptures at five-year intervals after extrahepatic portal obstruction and underwent successful treatments.
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokohji, Kamigyo-ku, Kyoto 602-8566, Japan. htan@koto.kpu-m.ac.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Michihisa
authors.initials: M
authors.lastname: Moriguchi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Amaike
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Fuji
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kosuga