<症例>到達困難な部位に生じた原発性肝細胞癌の2摘出例

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Two enucleated cases of hepatocellular carcinoma (HCC) with liver cirrhosis are presented. Their preoperative liver function studies indicated the danger of extensive hepatectomy. The first case was a 44-year-old female having a mass in the posterior portion of segment 7. A 23×22 mm mass of HCC was removed blindly by finger fracture method through the upper median skin incision. Transabdominal esophageal transection and splenectomy were also performed simultaneously. Although many complications influenced her postoperative course, she was free from signs and symptoms of HCC recurrence at 14 months from the surgery. The second case was a 54-year-old male having a mass in the right caudate lobe. On intraoperative ultrasonography, the mass was evidenced being adjacent and adherent to the right portal vein and inferior caval vein. Usual maneuver of partial hepatectomy including the mass failed because of massive bleeding from the portal vein. Aspiration of some contents of the mass by an ultrasonic scalpel made resultant enucleation of 45×35 mm HCC possible. He was free from recurrence of HCC at 12 months postoperatively. These specimens of HCC had well developed capsules. Limited partial hepatectomy, even the enucleation, for HCC associated with liver cirrhosis is an effective procedure to preserve liver functions and to expect sufficient survival for patients. If HCC, being adequate to such limited hepatectomy, is found in an unapproachable position of the liver, the HCC should be removed by using whole considerable methods.
近畿大学の論文
1986-06-25

<症例>到達困難な部位に生じた原発性肝細胞癌の2摘出例

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