[Hepatic inferior vena cava resection and vascular prosthesis reconstruction for locally advanced intrahepatic cholangiocarcinoma - a case report].
A 61-year-old woman was referred to our hospital because of jaundice and general itching. Computed tomography (CT) scan demonstrated that the tumor was located in the caudate lobe of the liver with hilar invasion and involved the hepatic inferior vena cava (IVC) and the right renal artery and vein. The patient was diagnosed with locally advanced intrahepatic cholangiocarcinoma, for which she underwent right hemihepatectomy with right caudate lobectomy, portal vein resection, hepatic IVC resection, extrahepatic bile duct resection, and right nephrectomy. IVC was reconstructed using vascular prosthesis by expanded polytetrafluoroethylene (ePTFE)-ringed graft. The patient's postoperative course was uneventful. The patient was treated with gemcitabine for postoperative chemotherapy, and 3 years after the operation, she died due to recurrence resulting from peritoneal dissemination. Although the thrombosis-related vascular prosthesis obstruction had occurred 2 years after the operation, no clinical symptom were noted, such as lower leg edema or renal dysfunction, during the postoperative course. Hepatic IVC prosthesis reconstruction for locally advanced cancer with extensive IVC invasion can be a useful surgical procedure for improving the resection rate and maintaining quality of life (QOL) in such cases.
Dept. of General Surgery, Graduate School of Medicine, Chiba University.
Masafumi
M
Fujino
Tsukasa
T
Takayashiki
Hiroaki
H
Shimizu
Masayuki
M
Ohtsuka
Atsushi
A
Kato
Hideyuki
H
Yoshitomi
Katsunori
K
Furukawa
Shigetsugu
S
Takano
Satoshi
S
Kuboki
Daiki
D
Okamura
Daisuke
D
Suzuki
Nozomu
N
Sakai
Shingo
S
Kagawa
Masaru
M
Miyazaki
D001650:Bile Duct Neoplasms / Q000098:blood supply / Q000150:complications / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D018281:Cholangiocarcinoma / Q000098:blood supply / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004621:Embolization, Therapeutic; D017809:Fatal Outcome; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009392:Nephrectomy; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*