title: Extended hemi-hepatectomy with portal vein reconstruction in a patient with situs ambiguous.
abstract: We report a case of far-advanced hepatocellular carcinoma (HCC) with situs ambiguous, complex visceral and vascular anomalies, who was successfully managed by extended hemi-hepatectomy. A 67-year-old man was referred to our hospital with a large liver mass. Abdominal ultrasonography, computed tomography and angiography revealed HCC with a diameter of 10 cm, with tumor thrombus in the main and first branch of the portal vein. Multiple complex anomalies in the abdomen were determined preoperatively. He had right-sided spleens-stomach-duodenum, liver at midline, inferior vena cava interruption with azygous continuation, and hepatic arterial anomaly. Extended left lobectomy of the liver with reconstruction of the portal vein was performed. Postoperatively, the patient recovered without major complications, and he was discharged on postoperative day 21. We report the first successful extended hepatectomy with portal vein reconstruction for HCC in a patient with rare situs anomalies.
authors.affiliation: Department of Surgery, Fukuoka City Hospital, Kyushu University, Fukuoka, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Sugimachi
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Morimasa
authors.initials: M
authors.lastname: Tomikawa
authors.forename: Katsumi
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Korenaga
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
authors.forename: Kenji
authors.initials: K
authors.lastname: Takenaka