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01.12.2012 | Technical innovations | Ausgabe 1/2012 Open Access

World Journal of Surgical Oncology 1/2012

Anatomical liver segmentectomy 2 for combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in segment 2 portal branch

Zeitschrift:
World Journal of Surgical Oncology > Ausgabe 1/2012
Autoren:
Hiromichi Ishii, Takuma Kobayashi, Michihiro Kudou, Masumi Nishimura, Atsushi Toma, Kenji Nakamura, Takeshi Mazaki, Tsuyoshi Itoh
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1477-7819-10-22) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

HI wrote the first draft of this report. HI, MN, and TI performed the operation. TM performed the pathological examination. HI is the guarantor of the paper. All authors read and approved the final manuscript.

Abstract

Background

Hepatic resection is the only effective treatment for combined hepatocellular carcinoma and cholangiocarcinoma.

Case presentation

A 52-year-old man was preoperatively diagnosed with hepatocellular carcinoma in segment 2 with tumor thrombus in the segment 2 portal branch. Anatomical liver segmentectomy 2, including separation of the hepatic arteries, portal veins, and bile duct, enabled us to remove the tumor and portal thrombus completely. Modified selective hepatic vascular exclusion, which combines extrahepatic control of the left and middle hepatic veins with occlusion of left hemihepatic inflow, was used to reduce blood loss. A pathological examination revealed combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in the segment 2 portal branch. No postoperative liver failure occurred, and remnant liver function was adequate.

Conclusion

The separation method of the hepatic arteries, portal veins, and bile duct is safe and feasible for a liver cancer patient with portal vein tumor thrombus. Modified selective hepatic vascular exclusion was useful to control bleeding during liver transection. Anatomical liver segmentectomy 2 using these procedures should be considered for a patient with a liver tumor located at segment 2 arising from a damaged liver.
Zusatzmaterial
Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 8
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Authors’ original file for figure 9
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Literatur
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