Imsamran W, Ratanachu-ek T
Department of Surgery, Rajavithi Hospital, Bangkok, Thailand.
J Med Assoc Thai. 1998 Aug;81(8):627-32.
We herein, report a 48-year-old Thai man with underlying Child A cirrhosis from chronic hepatitis B who complained of right upper abdominal pain. The imaging studies revealed an incomplete obstruction of the hepatic duct confluence with intrahepatic bile duct dilatation, predominantly on the right side. Hilar cholangiocarcinoma Bismuth Type IIIa was considered to be the diagnosis. Portal embolization of the right portal vein was performed by transileocecal approach, combined liver and bile duct resection with bilio-enteric anastomosis was carried out three weeks later. The postoperative course was uneventful. We believe that portal embolization may benefit patients with hilar cholangiocarcinoma by decreasing postoperative liver failure.
我们在此报告一名48岁的泰国男子,患有慢性乙型肝炎导致的Child A级肝硬化,主诉右上腹疼痛。影像学检查显示肝管汇合处不完全梗阻,肝内胆管扩张,主要在右侧。考虑诊断为肝门部胆管癌Bismuth IIIa型。通过经回盲部途径对右门静脉进行门静脉栓塞,三周后进行联合肝脏和胆管切除及胆肠吻合术。术后过程顺利。我们认为门静脉栓塞可能通过减少术后肝衰竭而使肝门部胆管癌患者受益。