A Case Report of Hepatectomy for Hepatocellular Carcinoma Accompanied with Caval Tumor Thrombus on the in Situ Perfused Liver

Koji Okuda, Kazusaburo Ando, Mikihisa Muta, Satoshi Taniwaki, Yuji Mada, Hiroshi Yasunaga, Toru Nakama, Kenichiro Uraguchi, Atsushige Ohryoji, Hideki Saitsu, Kenichi Kosuga, Toshimichi Nakayama, Kiroku Ohishi

Second Department of Surgery, Kurume University School of Medicine

Hepatocellular carcinoma accompanied with tumor thrombus in the inferior vena cava was resected. Tumor thrombus extended from the right hepatic vein to just below the right atrium. Mobilization and resection of the liver, partial resection of the vena cava and removal of the tumor thrombus were performed on the in situ hypothermic perfusion of the liver under vascular isolation. Bio-Medicus pump was used for Veno-veno bypass. Although the total ischemic time of the liver was 70 minutes, the liver seemed to be well preserved. The maximum postoperative values of GOT and TB were 187 K.U. and 2.6 mg/dl, respectively. Now, 15 months after operation, there is no evidence of recurrence. This case shows the feasibility of resection therapy for hepatocellular carcinoma severly invaded to the vena cava.

Key words
hepatocellular carcinoma, caval tumor thrombus, hepatectomy on the in situ perfused liver

Reprint requests
Koji Okuda Second Department of Surgery, Kurume University School of Medicine
67 Asahi-machi, Kurume, 830 JAPAN

Accepted
November 19, 1990

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