Wada H, Sasaki Y, Imaoka S, Shibata T, Nagano H, Ishikawa O, Ohigashi H, Furukawa H, Fukuda I, Kabuto T
Dept. of Surgery, Center for Adult Diseases, Osaka.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):2867-70.
A 45-year-old man was referred to our hospital due to obstructive jaundice by intrahepatic cholangiocellular carcinoma. At laparotomy, he was assessed as unresectable because of multiple foci in both lobes. Therefore, two catheters connected to implantable access devices were placed in both the hepatic artery and the portal vein following decollateralization using silicone rubber sheeting, in addition to choledochectomy and choledocho-jejunostomy. After the surgical procedure, he underwent chemoembolization twice using Lipiodol, cisplatin, and Gelfoam, and two intraportal infusions of cisplatin at a dose of 50 mg. Moreover, a total dose of 4 g of 5-FU and 20 mg of MMC was administered through the arterial and portal catheters, respectively. Administration of G-CSF was remarkably effective for severe thrombocytopenia, and leukopenia resulted from this active chemotherapy. He is still alive 7 months after the surgical procedure with the regression of the lesions.
一名45岁男性因肝内胆管细胞癌导致梗阻性黄疸被转诊至我院。剖腹探查时，因其两叶均有多个病灶，被评估为无法切除。因此，除了胆总管切除术和胆总管空肠吻合术外，在使用硅橡胶片进行去侧支循环后，将两根连接到植入式通路装置的导管分别置于肝动脉和门静脉。手术后，他使用碘油、顺铂和明胶海绵进行了两次化疗栓塞，并两次经门静脉输注50mg顺铂。此外，分别通过动脉和门静脉导管给予了总量为4g的5-氟尿嘧啶和20mg的丝裂霉素。给予粒细胞集落刺激因子（G-CSF）对严重血小板减少症有显著疗效，而这种积极的化疗导致了白细胞减少。手术7个月后他仍然存活，病灶有所消退。
