A Long Survival Case of Primary Operation for Hepatocellular Carcinoma Complicated with Esophageal Varices

Hideaki Yoshida, Naoyuki Nakatsuji*

Department of Surgery, Haibara Municipal General Hospital
*Department of Surgery, Hoshigaoka Koseinenkin Hospital

A 68-year-old woman was admitted because of hematemesis. An upper gastrointestinal series (UGI) and esophageal endoscopy revealed a rupture of esophageal varices. Computed tomography revealed hepatocellular carcinoma (HCC) in S₃. Primary left lateral segmentectomy, transabdominal esophageal transection with an EEA stapler gun with devasculalization and splenectomy were performed for treatment of the HCC and esophageal varices. The postoperative course was uneventful and there were no complicaitons. The histopathological findings indicated the Edmondson II type of HCC with liver cirhosis. Five years and 10 months after hepatectomy, recurrence of HCC was detected. Transcatheter arterial embolization was performed but the patient died of recurrence of HCC 7 years and 5 months after hepatectomy. No recurrence of varices was seen 7 years after the operation in a UGI. We concluded that hepatic resection and blocking operation can prolong the survival of patients with HCC complicated by esophageal varices.

Key words
hepatocellular carcinoma, esophageal varices, hepatectomy

Reprint requests
Hideaki Yoshida Department of Surgery, Haibara Municipal General Hospital
815 Hagihara, Haibara, Nara, 633-01 JAPAN

Accepted
September 9, 1992

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