title: [Two Cases of Systemic Steroid Therapy for Hyperbilirubinemia after Right Hepatic Lobectomy of Liver Metastasis from Colorectal Cancer].
abstract: We report 2 cases of systemic steroid therapy for hyperbilirubinemia after right hepatic lobectomy for liver metastases from colorectal cancer.One of the patients was a 65-year-old man, diagnosed with transverse colon cancer with multiple liver metastases.After surgery for the primary lesion and chemotherapy(FOLFOX plus bevacizumab, FOLFIRI plus panitumumab), he underwent right hepatic lobectomy for the liver metastasis.His preoperative ICG 15 min was 8%.Conjugated hyperbilirubinemia without biliary stenosis occurred after the hepatectomy.Two courses of pulse steroid therapy were effective for only a limited period.After initiation of oral prednisolone therapy, his hyperbilirubinemia decreased.The other patient was a 66- year-old man with rectal cancer who underwent a low anterior resection.Postoperatively, a liver metastasis appeared.After CapeOX therapy, he underwent right hepatic lobectomy.His preoperative ICG 15 min was 5%.Conjugated hyperbilirubinemia occurred after hepatectomy.Pulse steroid therapy was effective for only a limited period.After initiation of prednisolone therapy, his hyperbilirubinemia decreased.In both cases, fatty changes in the liver were detected.Chemotherapy -associated hepatotoxicity may induce hyperbilirubinemia after hepatectomy.The effectiveness of systemic steroid therapy for hyperbilirubinemia is demonstrated by these cases.
authors.affiliation: Dept. of Surgery, Japan Community Health care Organization(JCHO) Osaka Hospital.
authors.forename: Keigo
authors.initials: K
authors.lastname: Yasumasa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hatanaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Mizuno
authors.forename: Teruo
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Takafumi
authors.initials: T
authors.lastname: Hirao
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Noro
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakai
authors.forename: Hideki
authors.initials: H
authors.lastname: Osawa
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamasaki
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003082:Colectomy; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006801:Humans; D006932:Hyperbilirubinemia / Q000188:drug therapy* / Q000209:etiology; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013256:Steroids