title: [The role of preoperative percutaneous isolated hepatic perfusion and hepatectomy in multidisciplinary treatment].
abstract: We report a case of multiple bilobar hepatocellular carcinoma( HCC) that was successfully treated with a multidisciplinary treatment including preoperative percutaneous isolated hepatic perfusion and hepatectomy. The patient was a 61- year-old man who was detected as having HCC mainly in segment 4 and 8 of the liver and multiple bilobar intrahepatic metastasis during follow-up evaluation for chronic hepatitis B. Curative resection was difficult because the patient had insufficient liver function and because of the location of the tumor. Hence, we performed preoperative percutaneous isolated hepatic perfusion (PIHP) to control the multiple HCC. Seven weeks after the PIHP, the tumor size had reduced, and therefore we performed an extended left hepatic lobectomy. In addition to these treatment modalities, we performed transcatheter arterial chemoembolization (TACE) 3 times owing to recurrent HCC in the right liver lobe. Considering that HCC in segment 8 can be treated with TACE, we performed partial hepatectomy. As of the last follow-up visit, the patient was alive without disease recurrence. Thus, preoperative PIHP may improve the resectability rate in patients with multiple bilobar HCC for which curative resection is difficult to perform.
authors.affiliation: Dept. of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yoshida
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kido
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.forename: Shohei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Masanori
authors.initials: M
authors.lastname: Takahashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takebe
authors.forename: Motofumi
authors.initials: M
authors.lastname: Tanaka
authors.forename: Kaori
authors.initials: K
authors.lastname: Kuramitsu
authors.forename: Hisoka
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ajiki
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinzeki
authors.forename: Taro
authors.initials: T
authors.lastname: Okazaki
authors.forename: Sadaki
authors.initials: S
authors.lastname: Asari
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D008297:Male