Takayama T, Nakatsuka T, Shimada K, Yamamoto J, Kosuge T, Yamasaki S, Hirai Y, Makuuchi M
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Hepatogastroenterology. 1995 Jul-Aug;42(4):415-7.
BACKGROUND/AIMS: A cirrhotic case of hepatocellular carcinoma (HCC) complicating portal vein tumor thrombi which underwent posterior segmentectomy with anterior portal venoplasty is reported.
The HCC originated in the right posterior segment and grew intraluminally up to the right portal vein, and the laboratory data indicated a presence of severe cirrhosis. The operative procedure undertaken consisted of internal shunting of the portal blood stream by mesentero-umbilical bypass, resection of the posterior segment and the anterior portal venous root, and reconstruction of the anterior portal branch by patch grafting.
This operation produced no distinct complications, and it was defined pathologically as being curative.
The case here introduces rationale of this modified hepatic segmentectomy in view of functional preservation of the residual cirrhotic liver.
背景/目的：报告1例肝细胞癌（HCC）合并门静脉瘤栓的肝硬化病例，该病例接受了右后叶切除术及门静脉前壁成形术。
该HCC起源于右后叶，向管腔内生长至右门静脉，实验室检查提示存在严重肝硬化。手术过程包括通过肠系膜-脐静脉旁路进行门静脉血流内分流、切除右后叶及门静脉前壁根部，并通过补片移植重建门静脉前支。
该手术未产生明显并发症，病理检查确定为根治性手术。
鉴于保留残余肝硬化肝脏的功能，本文病例介绍了这种改良肝段切除术的理论依据。
