Suzuki Takayuki, Takayashiki Tsukasa, Shimizu Hiroaki, Ohtsuka Masayuki, Kato Atsushi, Yoshitomi Hideyuki, Furukawa Katsunori, Takano Shigetsugu, Kuboki Satoshi, Okamura Daiki, Suzuki Daisuke, Sakai Nozomu, Kagawa Shingo, Miyazaki Masaru
Dept. of General Surgery, Graduate School of Medicine, Chiba University.
Gan To Kagaku Ryoho. 2014 Nov;41(12):1536-8.
A 70-year-old man was diagnosed with local recurrence 1 and half years after pancreatoduodenectomy for extrahepatic cholangiocarcinoma. Progression of the recurrent tumor involved the portal vein, even though the patient had received chemotherapy (gemcitabine). Although no clinical symptoms caused by portal venous stenosis were found at the time, we performed percutaneous transhepatic portal vein stenting to avoid interrupting chemotherapy. Eighteen months after this procedure, the patency of the portal vein stent was well maintained, and the patient was treated with S-1 chemotherapy continuously without any symptoms related to portal venous stenosis reported. Prophylactic portal vein stenting without clinical symptoms of portal vein stenosis is a useful procedure, not only for palliative care but for improving the prognosis of patients with cholangiocarcinoma by continuous chemotherapy.
一名70岁男性在接受肝外胆管癌胰十二指肠切除术后1年半被诊断为局部复发。尽管患者接受了化疗（吉西他滨），但复发性肿瘤仍进展累及门静脉。虽然当时未发现由门静脉狭窄引起的临床症状，但为避免中断化疗，我们进行了经皮经肝门静脉支架置入术。该手术后18个月，门静脉支架通畅情况良好，患者持续接受S-1化疗，未报告任何与门静脉狭窄相关的症状。在没有门静脉狭窄临床症状的情况下进行预防性门静脉支架置入术是一种有用的方法，不仅用于姑息治疗，还可通过持续化疗改善胆管癌患者的预后。
