Two-step hepatectomy with right portal branch ligature for a right lobe metastasis.
Hepatic resection is the only treatment with possible curative effect both for primary and secondary tumors. An increase of the rate of resectability for tumors considered inoperable at first, and a decrease of the postoperative morbidity and mortality can be realized by right portal branch ligature and two-step hepatectomy. We would like to present the case of a patient with left bowel cancer with a hepatic metastasis. Right portal branch ligature was performed which was followed by systemic postoperative chemotherapy. The right portal branch occlusion was followed by right lobe atrophy and left lobe hypertrophy, confirmed by CT scanning. Three months after the portal occlusion the patient underwent a right lobe hepatectomy. The postoperative evolution was favorable, eight days of hospitalization were necessary. The portal branch ligature can be made in several cases of hepatic tumors to increase the resectability rate.
Bara
T
T
Surgical Clinic No. 2, Tg. Mures, Mures County, Romania. baratibadar@yahoo.com
Bancu
S
S
Gyorgy-Fazakas
I
I
Muresan
M
M
Bara
T
T
Podeanu
Daniela
D
Muresan
Simona
S
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D000328:Adult; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D003131:Combined Modality Therapy; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008026:Ligation; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D011169:Portal Vein / Q000601:surgery*; D014057:Tomography, X-Ray Computed