[Useful device for hepatectomy in patients with a surgical history of bile duct-GI tract anastomosis at the porta hepatis].
We experienced three hepatectomies in patients with a history of bile duct-gastrointestinal (GI) tract anastomosis at the porta hepatis. Patient 1 had a history of pancreaticoduodenectomy for bile duct cancer. Because the third liver metastasis of cecal cancer postoperatively invaded the right kidney, after 5 courses of FOLFOX we performed partial resection of the liver (S6) and the right kidney using microwave pre-coagulation and a cavitron ultrasonic surgical aspirator (CUSA) without the Pringle method. Patient 2 had a history of splenectomy for congenital spherocytosis, cholecystectomy, choledocholithotomy, and bile duct duodenal anastomosis for hepatolithiasis. Partial (S5) liver resection was performed to treat hepatocellular carcinoma. Patient 3 had a history of bile duct resection and choledochojejunostomy for congenital cystic dilatation of the common bile duct. She had repeated episodes of cholangitis in the year following surgery. Extended liver segmental (S4) resection was performed to treat intrahepatic bile duct carcinoma. Bile duct jejunum anastomosis was performed, and the portal vein and the hepatic artery in the porta hepatis were exfoliated. Hepatectomy was performed using the Pringle method and a CUSA. Surgical procedures using various devices are necessary for hepatectomy in patients with a history of bile duct-GI tract anastomosis at the porta hepatis.
Dept. of Gastroenterological Surgery, Saitama Cancer Center.
Katsumi
K
Amikura
Hirohiko
H
Sakamoto
Amane
A
Takahashi
Toshiro
T
Ogura
Kiyohiko
K
Omichi
Kazuhisa
K
Ehara
Takashi
T
Fukuda
Toshimasa
T
Yatsuoka
Yoshiyuki
Y
Kawashima
Yoichi
Y
Tanaka
D000368:Aged; D000714:Anastomosis, Surgical; D001652:Bile Ducts / Q000601:surgery; D001662:Biliary Tract Surgical Procedures; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male