Akatsuka Masako, Nakajima Takayoshi, Ikuta Shinichi, Aihara Tsukasa, Kusunoki Kurando, Kitamura Yu, Ichise Noriko, Hamano Ikumi, Okamoto Ryo, Nakamoto Yoshihiko, Kimura Fumihiko, Yanagi Hidenori, Kakuno Ayako, Yamanaka Naoki
Dept. of Surgery, Meiwa Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):1815-1817.
A 74-year-old man was admitted to a local hospital with liver dysfunction. Imaging modalities revealed bile duct stenosis at the bifurcation of the anterior and posterior trunk. Exfoliative cytology of the bile and brushing cytology of the bile duct both revealed Class Ⅴ, and biopsy from the stenotic bile duct showed well differentiated adenocarcinoma. We diagnosed the patient with hilar cholangiocarcinoma and performed extended right bisectionectomy and biliary reconstruction after percuta- neous transhepatic right portal vein embolization(PTPE). Preoperatively, he was administered S-1(80mg/body weight/day) orally for 19 days. Histopathological assessment of the resected specimen revealed hemosiderin-laden macrophages without viable cancer cells, confirmingpatholog ical complete response(pCR).
一名74岁男性因肝功能不全入住当地医院。影像学检查显示肝门前后干分叉处胆管狭窄。胆汁脱落细胞学检查和胆管刷检细胞学检查均显示为Ⅴ级，狭窄胆管活检显示为高分化腺癌。我们诊断该患者为肝门部胆管癌，并在经皮经肝右门静脉栓塞术（PTPE）后进行了扩大右半肝切除术和胆道重建。术前，他口服S-1（80mg/体重/天），共19天。切除标本的组织病理学评估显示有含铁血黄素的巨噬细胞，无存活癌细胞，证实为病理完全缓解（pCR）。
