Korean J Gastroenterol.  2011 Sep;58(3):162-165. 10.4166/kjg.2011.58.3.162.

Right Hepatectomy in a Patient with Hepatocellular Carcinoma after Induction of Hepatic Parenchymal Atrophy through Subsequent Portal and Hepatic Vein Embolizations

• Hwang S

• KMID: 1018406
• DOI: http://doi.org/10.4166/kjg.2011.58.3.162

Abstract

No abstract available.

MeSH Terms

Antineoplastic Agents/administration & dosage
Antiviral Agents/therapeutic use
Atrophy/pathology
Carcinoma, Hepatocellular/pathology/radiography/*therapy
*Chemoembolization, Therapeutic
Hepatectomy
*Hepatic Veins
Hepatitis B, Chronic/complications/diagnosis/drug therapy
Humans
Liver Neoplasms/pathology/radiography/*therapy
Male
Middle Aged
*Portal Vein
Tomography, X-Ray Computed

Figure

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  Fig. 1. Initial application of transarterial chemoembolization. (A) Hepatic arteriogrphy shows a large-sized hypervascular mass at the right liver. (B) Two weeks after embolization, CT showed extensive tumor necrosis but incomplete lipiodol uptake, implica-ting presence of viable tumor cells.

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  Fig. 2. Preoperative right portal vein embolization. (A) The portal vein system was visualized through percutaneous ipsilateral approach. (B) After occlusion of the right portal vein with multiple coils and gelfoam, only the left portal vein was visualized.

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  Fig. 3. Subsequent right hepatic vein embolization following right portal vein embolization. (A) The right hepatic vein was visualized through transjugular approach. (B) The right hepatic vein was occluded with multiple coils and a vascular plug (arrow).

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  Fig. 4. Computed tomography images following right portal and hepatic vein embolizations. (A) There were little hemi-liver volume changes 2 weeks after hepatic vein embolization. (B) A slight further atrophy of the right liver was found 2 months after hepatic vein embolization.

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  Fig. 5. Computed tomography images before and after right hepatectomy. (A) Marked atrophy of the right liver was found at the 15 months after hepatic vein embolization. (B) CT taken 1 week after surgery showed prominent regeneration of the remnant left liver.

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  Fig. 6. Gross finding of the resected right liver specimen. The hepatocellular carcinoma was nearly completely necrotic due to repeated chemoembolization, with background cirrhosis of mixed micro-and macro-nodular type.

Reference

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