Enomoto Katsuhisa, Amano Sadao, Sakurai Kenichi
Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.
Gan To Kagaku Ryoho. 2006 Nov;33(12):1907-9.
A Treatment by a Bile Duct Stent Obtaining High Efficacy: Katsuhisa Enomoto, Sadao Amano and Kenichi Sakurai (Division of Breast and Breast cancer hepatic metastasis with icterus is poor in prognosis and an active treatment is hardly performed. However, we improved patients' QOL by inserting a bile duct stent as a topical treatment. CASE 1: A 63-year-old woman was seen having left breast cancer. We performed a modified radical mastectomy and axillary lymph node in January 1989. Since then, we continued chemotherapy and hormonal therapy. In the 16th year after the operation, we confirmed a liver functional impairment and saw an increase in T-Bil to be 5.5 mg/dl. We also confirmed multiple hepatic metastases and intrahepatic bile duct dilation. We detained a bile duct stent and performed a treatment to decrease the icterus. It has been three months since the insertion of the stent, but we have not confirmed the rise of T-Bil. CASE 2: A 49-year-old woman was seen having right breast cancer. We performed a modified radical mastectomy in June 2000. We confirmed multiple hepatic metastases in October 2005 and inserted a bile duct stent because we detected an expansion of the intrahepatic bile duct. In conclusion, it appears that a bile duct stent has improved patients' QOL in the cases where obstructive jaundice developed with breast cancer hepatic metastasis.
榎本胜久、天野贞夫和樱井健一(乳腺科)。伴有黄疸的乳腺癌肝转移患者预后较差,难以进行积极治疗。然而,我们通过插入胆管支架作为局部治疗改善了患者的生活质量。病例1:一名63岁女性,患有左乳腺癌。1989年1月我们进行了改良根治性乳房切除术和腋窝淋巴结清扫术。此后,我们持续进行化疗和激素治疗。术后第16年,我们确认肝功能受损,总胆红素升至5.5mg/dl。我们还确认了多处肝转移和肝内胆管扩张。我们留置了胆管支架并进行了减轻黄疸的治疗。自插入支架以来已有三个月,但我们未确认总胆红素升高。病例2:一名49岁女性,患有右乳腺癌。2000年6月我们进行了改良根治性乳房切除术。2005年10月我们确认了多处肝转移,并因检测到肝内胆管扩张而插入了胆管支架。总之,在乳腺癌肝转移并发梗阻性黄疸的病例中,胆管支架似乎改善了患者的生活质量。