Gan to kagaku ryoho. Cancer & chemotherapy · 2025
[A Case of Intrahepatic Cholangiocarcinoma Treated with Extended Right Hepatectomy with Partial Resection of the Inferior Vena Cava Following Laparoscopic Portal Vein Ligation].
СтатьяКлинический случайАннотация на английскомНазвание и аннотация: Перевод в очереди
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Aiyama Takeshi, Kakisaka Tatsuhiko, Yamamoto Yoichi, Shichi Shunsuke, Fujii Yuki, Fujiyoshi Sunao, Nagatsu Akihisa, Kawamura Norio, Watanabe Masaaki, Goto Ryoichi, Taketomi Akinobu
Аннотация
INTRODUCTION: Portal vein embolization(PVE)is a preoperative procedure that requires contrast media, making it contraindicated in patients with a history of contrast-induced anaphylaxis. We report a case of intrahepatic cholangiocarcinoma (ICC)in which laparoscopic right portal vein ligation(PVL)was performed as an alternative to PVE due to this contraindication.
CASE: A 60-year-old woman was found to have a liver tumor during a health checkup. Further evaluation led to a diagnosis of ICC. The tumor was in close contact with the right and middle hepatic veins and the inferior vena cava(IVC) and showed enlarged hilar and para-aortic lymph nodes(#16b1). Surgery was initially deemed unfeasible at another hospital, and systemic chemotherapy(GEM+CDDP+durvalumab)was initiated, maintaining stable disease for approximately 1 year. She was referred for potential conversion surgery. Although PVE was indicated, it was contraindicated due to a history of contrast anaphylaxis. Therefore, laparoscopic right PVL was performed instead. On postoperative day 26, extended right hepatectomy with partial IVC resection, cholecystectomy, and lymphadenectomy(including #16b1 int & lat)was performed. Aside from autosensitization dermatitis, her postoperative course was uneventful, and she was discharged on day 17.
CONCLUSION: Laparoscopic PVL is a safe and effective alternative to PVE in patients with contrast contraindications.
CASE: A 60-year-old woman was found to have a liver tumor during a health checkup. Further evaluation led to a diagnosis of ICC. The tumor was in close contact with the right and middle hepatic veins and the inferior vena cava(IVC) and showed enlarged hilar and para-aortic lymph nodes(#16b1). Surgery was initially deemed unfeasible at another hospital, and systemic chemotherapy(GEM+CDDP+durvalumab)was initiated, maintaining stable disease for approximately 1 year. She was referred for potential conversion surgery. Although PVE was indicated, it was contraindicated due to a history of contrast anaphylaxis. Therefore, laparoscopic right PVL was performed instead. On postoperative day 26, extended right hepatectomy with partial IVC resection, cholecystectomy, and lymphadenectomy(including #16b1 int & lat)was performed. Aside from autosensitization dermatitis, her postoperative course was uneventful, and she was discharged on day 17.
CONCLUSION: Laparoscopic PVL is a safe and effective alternative to PVE in patients with contrast contraindications.