Open AccessResection of a locally advanced hilar tumor and the hepatic artery after stepwise hepatic arterial embolization: A case report
Author(s) -
Takuya Miura,
Kenichi Hakamada,
Takashi Ohata,
Shunji Narumi,
Yoshikazu Toyoki,
Masaki Nara,
Keinosuke Ishido,
Motonari Ohashi,
Harue Akasaka,
Hiroyuki Jin,
Norihito Kubo,
Sachiko Ono,
Hiroshi Kijima,
Mutsuo Sasaki
Publication year - 2008
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.14.3587
Subject(s) - medicine , hepatectomy , left hepatic duct , artery , embolization , arterial embolization , surgery , inferior mesenteric artery , radiology , bile duct , resection
We herein report a case of a hilar tumor with extensive invasion to the proper hepatic artery, which was successfully treated with a radical resection in a 57-year-old female patient after a stepwise hepatic arterial embolization. She underwent right colectomy and partial hepatectomy for advanced colon cancer two years ago and radiofrequency ablation therapy for a liver metastasis one year ago, respectively. A recurrent tumor was noted around the proper hepatic artery with invasion to the left hepatic duct and right hepatic artery 7 mo previously. We planned a radical resection for the patient 5 mo after the absence of tumor progression was confirmed while he was undergoing chemotherapy. To avoid surgery-related liver failure, we tried to promote the formation of collateral hepatic arteries after stepwise arterial embolization of the posterior and anterior hepatic arteries two weeks apart. Finally, the proper hepatic artery was occluded after formation of collateral flow from the inferior phrenic and superior mesenteric arteries was confirmed. One month later, a left hepatectomy with hepatic arterial resection was successfully performed without any major complications.