Tsukamoto Tadashi, Kanazawa Akishige, Shimizu Sadatoshi, Sakae Masayuki, Kurihara Shigeaki, Tashima Tetsuzo, Deguchi Sota, Goto Wataru, Kotsuka Masaya, Ishikawa Akira, Yoshii Mami, Nakajima Takayoshi, Mori Yukihiro, Ohira Go, Tachimori Akiko, Tamamori Yutaka, Yamamoto Atsushi, Inoue Toru, Yamashita Yoshito, Nishiguchi Yukio
Dept. of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital.
Gan To Kagaku Ryoho. 2014 Nov;41(12):1539-41.
The stenting strategy for portal vein stenosis in cases with unresectable hilar malignancies reduces portal hypertension and maintains portal vein blood flow. This not only improves quality of life, but also leads to aggressive therapy with anticancer agents. A 65-year-old woman presented with painless jaundice 8 months after left hemihepatectomy with lymph node dissection for intrahepatic cholangiocellular carcinoma. Seven months after biliary stenting for bile duct stenosis, progressing pancytopenia and ascites were noted. Imaging studies revealed portal vein stenosis by the tumor at the hepatic hilum. Percutaneous transhepatic portal vein stent placement was performed, and pancytopenia and ascites improved immediately thereafter. Chemotherapy for recurrence of intrahepatic cholangiocellular carcinoma at the hepatic hilum has been initiated, and the patient has been alive 15 months since.
对于无法切除的肝门部恶性肿瘤患者，门静脉狭窄的支架置入策略可降低门静脉高压并维持门静脉血流。这不仅改善了生活质量，还能使患者接受积极的抗癌药物治疗。一名65岁女性在因肝内胆管细胞癌行左半肝切除及淋巴结清扫术后8个月出现无痛性黄疸。在因胆管狭窄行胆道支架置入术后7个月，出现进行性全血细胞减少和腹水。影像学检查显示肝门部肿瘤导致门静脉狭窄。遂行经皮经肝门静脉支架置入术，术后全血细胞减少和腹水立即改善。目前已开始针对肝门部肝内胆管细胞癌复发进行化疗，患者至今已存活15个月。
