Hamazaki K, Yagi T, Inagaki M, Tanaka N, Mimura H, Orita K, Lygidakis N J
First Department of Surgery, Okayama University Medical School, Japan.
Hepatogastroenterology. 1994 Apr;41(2):150-3.
Liver metastasis located at the confluence of the major hepatic veins developed after an operation for sigmoid colon carcinoma in a 63-year-old patient. Curative resection of the tumor was performed by in situ hypothermic perfusion of the liver and extracorporeal circulation. Intra-abdominal bleeding occurred on the first postoperative day, and ligation of the right inferior phrenic artery was performed via an emergency laparotomy. Only mild elevation of ALT and recovery of the arterial ketone body ratio to the "safety zone" was noted on the second postoperative day. Hepatic function gradually deteriorated after the 4th postoperative day with no distinct cause. Diffuse fatty liver was suspected as a cause of liver failure. The patient died on the 31st postoperative day. The problems encountered in this case are discussed in this paper.
一名63岁患者在乙状结肠癌手术后出现位于肝主要静脉汇合处的肝转移。通过肝脏原位低温灌注和体外循环对肿瘤进行了根治性切除。术后第一天发生腹腔内出血，通过急诊剖腹手术结扎了右膈下动脉。术后第二天仅观察到谷丙转氨酶轻度升高以及动脉酮体比值恢复到“安全区”。术后第4天起肝功能逐渐恶化，无明显原因。怀疑弥漫性脂肪肝是肝衰竭的原因。患者于术后第31天死亡。本文讨论了该病例中遇到的问题。
