脾摘出術・胃上部血行郭清術後, 凝固焼灼 (ラジオ波) を行った肝硬変併存肝細胞癌の1例

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A 72-year-old woman was admitted for suspected liver tumor. The abdominal CT showed a hepatocellular carcinoma (HCC) 4.5 cm in diameter in her cirrhotic liver, splenomegaly and large porto-systemic shunts in the periesophagogastric region. Fiberscopic examination revealed risky esophageal varix (EV), and the labolatory data showed pancytopenia of hypersplenism and poor liver function. We decided to perform a gastroesophageal decongestion and splenectomy (Hassab operation) for her EV, large porto-systemic shunts and hypersplenism before partial hepatectomy for the HCC. Although we performed Hassab operation successfully, she suffered from portal vein thrombus and ascitic fluid that could not be controlled by medication after the operation. We gave up the idea of hepatectomy, and performed radiofrequency ablation therapy for the HCC. She discharged from hospital uneventfully, and are alive now free from HCC.
特定非営利活動法人 Microwave Surgery研究会の論文