Oura Tatsushi, Kageyama Ken, Kimura Kenjiro, Yamamoto Akira, Tauchi Jun, Nishio Kohei, Murai Kazuki, Nakano Mariko M, Jogo Atsushi, Ishizawa Takeaki, Miki Yukio
Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Japan.
Department of Hepato-Biliary-Pancreatic Surgery, Graduate School of Medicine, Osaka Metropolitan University, Japan.
Interv Radiol (Higashimatsuyama). 2025 Jan 28;10:e20240009. doi: 10.22575/interventionalradiology.2024-0009. eCollection 2025 Mar 28.
A 60-year-old male presented with jaundice. He had a history of extended left hepatectomy, cholecystectomy, hepaticojejunostomy for moderately to poorly differentiated hepatocellular carcinoma, and transverse colectomy for transverse colon cancer. Computed tomography showed hepatocellular carcinoma recurrence in the liver, extending from the hepaticojejunostomy site to the elevated jejunum, resulting in obstructive jaundice. Internal biliary drainage using a percutaneous transhepatic approach was planned. However, the guidewire could not pass through the obstruction caused by the tumor at the hepaticojejunostomy site. After performing hepatic arterial infusion chemotherapy, to reduce the tumor volume, transcatheter arterial chemoembolization was performed for hepatocellular carcinoma recurrence. After transcatheter arterial chemoembolization, the catheter was successfully advanced beyond the tumor at the elevated jejunum owing to tumor shrinkage, thus completing internal biliary drainage.
一名60岁男性出现黄疸。他有接受过扩大左肝切除术、胆囊切除术、因中低分化肝细胞癌行肝空肠吻合术以及因横结肠癌行横结肠切除术的病史。计算机断层扫描显示肝脏中肝细胞癌复发，从肝空肠吻合部位延伸至高位空肠，导致梗阻性黄疸。计划采用经皮经肝途径进行内胆管引流。然而，导丝无法穿过肝空肠吻合部位由肿瘤造成的梗阻。在进行肝动脉灌注化疗以缩小肿瘤体积后，对复发性肝细胞癌进行了经导管动脉化疗栓塞术。经导管动脉化疗栓塞术后，由于肿瘤缩小，导管成功越过高位空肠处的肿瘤，从而完成了内胆管引流。
