Miura T, Hakamada K, Ohata T, Narumi S, Toyoki Y, Nara M, Ishido K, Ohashi M, Akasaka H, Jin H, Kubo N, Ono S, Kijima H, Sasaki M. Resection of a locally advanced hilar tumor and the hepatic artery after stepwise hepatic arterial embolization: A case report. World J Gastroenterol 2008; 14(22): 3587-3590 [PMID: 18567092 DOI: 10.3748/wjg.14.3587]
Corresponding Author of This Article
Kenichi Hakamada, MD, Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan. hakamada@cc.hirosaki-u.ac.jp
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Takuya Miura, Kenichi Hakamada, Shunji Narumi, Yoshikazu Toyoki, Masaki Nara, Keinosuke Ishido, Motonari Ohashi, Harue Akasaka, Hiroyuki Jin, Norihito Kubo, Mutsuo Sasaki, Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
Takashi Ohata, Shuichi Ono, Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
Motonari Ohashi, Harue Akasaka, Hiroyuki Jin, Hiroshi Kijima, Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan
Author contributions: Hakamada K, Narumi S, Toyoki Y, Nara M, Ishido K Kubo N and Sasaki M followed the patient; Ohata T and Ono S performed the radiological intervention; Ohashi M, Akasaka H, Jin H and Kijima H performed the pathologic evaluation; Miura T wrote the paper; Hakamada K supervised the writing.
Correspondence to: Kenichi Hakamada, MD, Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki 036-8562, Japan. hakamada@cc.hirosaki-u.ac.jp
Telephone: +81-172-395079
Fax: +81-172-395080
Received: February 5, 2008 Revised: May 12, 2008 Accepted: May 19, 2008 Published online: June 14, 2008
Abstract
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.
