Ohwada S, Kawashima Y, Ogawa T, Ohya T, Takeyoshi I, Saito A, Kawashima K, Morishita Y
Second Department of Surgery, Gunma University School of Medicine, Japan.
Hepatogastroenterology. 1999 Mar-Apr;46(26):1151-5.
A 69 year-old man with a history of thoracoplastic surgery for pulmonary tuberculosis, who required a blood transfusion and subsequently tested positive for hepatitis C virus, developed a right hypochondrial mass, swelling of the lower extremities and malaise. A huge hepatocellular carcinoma invading the suprahepatic vena cava with tumor thrombi was diagnosed radiographically. An extended right hepatectomy with supra- to retrohepatic IVC resection was performed in an en bloc fashion using a centrifugal pump for hepatic vascular exclusion (HVE). The supra- to retrohepatic IVC was replaced with an expanded polytetrafluoroethylene (ePTFE) graft, 20 mm x 10 cm in size, and the left hepatic venous confluence was reconstructed. Twenty-one months after surgery, the patient is in good condition without recurrence of tumor.
一名69岁男性,有因肺结核接受胸廓成形术的病史,曾接受输血,随后丙型肝炎病毒检测呈阳性,出现右季肋部肿块、下肢肿胀和不适。影像学诊断为巨大肝细胞癌侵犯肝上腔静脉并伴有瘤栓。采用离心泵进行肝血管阻断(HVE),以整块切除的方式实施了扩大的右肝切除术,包括肝上至肝后下腔静脉切除。用尺寸为20mm×10cm的膨体聚四氟乙烯(ePTFE)移植物替换肝上至肝后下腔静脉,并重建左肝静脉汇合处。术后21个月,患者状况良好,无肿瘤复发。