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Rupture of the hepatic artery after left hemihepatectomy for hilar bile duct carcinoma
Author(s) -
Tanaka Hiromu,
Hirohashi Kazuhiro,
Ohta Yasuhiro,
Kimura Eiji,
Shuto Taichi,
Kanazawa Akishige,
Yamamoto Takatsugu,
Kinoshita Hiroaki
Publication year - 1995
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02349267
Subject(s) - medicine , left hepatic duct , hilum (anatomy) , artery , common hepatic duct , bile duct , jaundice , dissection (medical) , radiology , carcinoma , common bile duct , surgery
Abstract Hilar bile duct carcinoma has a poor prognosis, but this has been improved in recent years by an aggressive surgical approach. We treated a 73‐year‐old woman who had obstructive jaundice due to bile duct carcinoma at the hepatic hilum. The jaundice decreased after percutaneous transhepatic biliary drainage. The tumor was resected with the left and caudate lobe of the liver and a part of portal vein. The right hepatic artery was located behind the common hepatic duct, and was suspected to be invaded by the tumor. We dissected the tumor from the arterial wall without carrying out combined resection of the hepatic artery. On the 6th postoperative day, the hepatic artery ruptured and the patient suffered hypovolemic shock. Resection of the hepatic artery and reconstruction were done, but the patient died 2 days later. Histological examination of the resected artery showed that the tumor had been curatively removed by dissection and that no tumor remained at the arterial wall. The rupture of the right hepatic artery was thought to have been caused by damage to the wall during the dissection procedure.