Resection of a locally advanced hilar tumor and the hepatic artery after stepwise hepatic arterial embolization: A case report

作     者：Takuya Miura Kenichi Hakamada Takashi Ohata Shunji Narumi Yoshikazu Toyoki Masaki Nara Keinosuke Ishido Motonari Ohashi Harue Akasaka Hiroyuki Jin Norihito Kubo Shuichi Ono Hiroshi Kijima Mutsuo Sasaki 

作者机构：Department of Gastroenterological Surgery Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Radiology and Radiation Oncology Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Gastroenterological Surgery Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Pathology and Bioscience Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan Department of Pathology and Bioscience Hirosaki University Graduate School of Medicine Hirosaki 036-8562 Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第22期

页      面：3587-3590页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Hepatic arterial embolization Stepwise Hilar tumor Arterial resection Collateral artery 

摘      要：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 embolizationof 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.