Yoshimoto Yutaro, Orita Hajime, Yamauchi Suguru, Kaji Sanae, Fukunaga Tetsu
Department of Upper Gastrointestinal Surgery, Juntendo University Hospital, Tokyo, JPN.
Cureus. 2022 Apr 8;14(4):e23960. doi: 10.7759/cureus.23960. eCollection 2022 Apr.
Agenesis of the left hepatic lobe is an exceedingly rare morphological anomaly. Moreover, agenesis of the left hepatic lobe accompanied by esophagogastric cancer is even rarer, with no reports to date. Agenesis of the hepatic lobe is commonly related to some anatomical variations of the gastrohepatic system. A 76-year-old man was referred to our hospital for surgery for esophagogastric cancer with short Barrett's esophagus. Multiple preoperative imaging modalities revealed agenesis of the left hepatic lobe accompanied by esophagogastric cancer. Robotic proximal gastrectomy and transhiatal lower esophagectomy were performed. Intraoperative findings showed agenesis of the left hepatic lobe. The patient's postoperative course was favorable. Today, 16 months after surgery, the patient is alive without recurrence of esophagogastric cancer. We report a case of agenesis of the left hepatic lobe in a patient undergoing robotic proximal gastrectomy and transhiatal lower esophagectomy for esophagogastric cancer. Preoperative comprehension of various visceral anomalies reduces the risk of surgical complications.
左肝叶发育不全是一种极其罕见的形态学异常。此外,左肝叶发育不全伴发食管胃癌的情况更为罕见,迄今为止尚无相关报道。肝叶发育不全通常与胃肝系统的一些解剖变异有关。一名76岁男性因患有短Barrett食管的食管胃癌被转诊至我院接受手术治疗。多种术前影像学检查显示左肝叶发育不全伴发食管胃癌。遂行机器人近端胃切除术和经裂孔食管下段切除术。术中发现左肝叶发育不全。患者术后恢复良好。如今,术后16个月,患者存活,食管胃癌未复发。我们报告一例在接受机器人近端胃切除术和经裂孔食管下段切除术治疗食管胃癌的患者中出现左肝叶发育不全的病例。术前了解各种内脏异常可降低手术并发症的风险。