Komiyama Sosuke, Izumiya Yasuhito, Kimura Yu, Nakashima Shingo, Kin Syuichi, Kawakami Sadao
Dept. of Surgery, Fukuchiyama City Hospital.
Gan To Kagaku Ryoho. 2018 Mar;45(3):560-562.
A 70-year-old man with distal bile duct carcinoma underwent a subtotal stomach-preserving pancreaticoduodenectomy without adjuvant chemotherapy. One and a half years after the surgery, elevated levels of serum SPan-1(38.1 U/mL)were observed and CT scans demonstrated a solitary metastasis, 25mm in size, in segment 8 of the liver. The patient received 2 courses of gemcitabine-cisplatin combination chemotherapy. No new lesions were detected after chemotherapy and the patient underwent a partial liver resection of segment 8. The pathological examination revealed a metachronous distant metastasis originating from the bile duct carcinoma. Subsequently, the patient received S-1 adjuvant chemotherapy for 6 months. Following completion of all therapies, the patient survived without tumor recurrence for 3 years and 10 months after the initial operation. Thus, surgical interventions might be effective in improving prognosis among selected patients with postoperative liver metastasis of bile duct carcinoma.
一名70岁的远端胆管癌男性患者接受了保留胃的胰十二指肠次全切除术，未进行辅助化疗。术后一年半，血清SPan-1水平升高（38.1 U/mL），CT扫描显示肝脏第8段有一个25mm大小的孤立转移灶。患者接受了2个疗程的吉西他滨-顺铂联合化疗。化疗后未发现新病灶，患者接受了肝脏第8段部分切除术。病理检查显示为源自胆管癌的异时性远处转移。随后，患者接受了6个月的S-1辅助化疗。完成所有治疗后，患者在初次手术后无肿瘤复发存活了3年10个月。因此，手术干预可能对改善部分胆管癌术后肝转移患者的预后有效。
