An Experience of Radical Operation for Synchronous Hepatic Hilar Bile Duct and Rectal Cancers in a Patient on Maintenance Hemodialysis

Shin-ichi Ikuta, Kazuo Hatsuse, Nobuaki Kawarabayashi, Tsukasa Aihara and Hidetaka Mochizuki

First Department of Surgery, National Defence Medical College

A 48-year-old man, maintained on hemodialysis for 10 years, was admitted to our hospital for treatment of rectal cancer. Preoperative examination revealed synchronous cancer of the hepatic hilar bile duct. Extended right hepatic lobectomy and caudate lobectomy with bile duct resection were performed first, for the hepatic hilar bile duct cancer, and 17 weeks later Hartmann's operation was carried out for the rectal cancer. The patient received intensive hemodialysis for 3 consecutive days before the operation, postoperative hemodialysis, and hemodynamic monitoring with Swan-Ganz catheter, and the postoperative course was uneventful, with no bleeding, overhydration, hyperkalemia, or liver failure. This case suggests that intensive perioperative care can enable regular hemodialysis patients to undergo highly stressful operations, such as major hepatectomy, without critical complications.

Key words
patient on maintenance hemodialysis, colorectal carcinoma, hepatic hilar bile duct carcinoma

Reprint requests
Shin-ichi Ikuta First Department of Surgery, National Defence Medical College 3-2 Namiki, Tokorozawa, Saitama, 359-8513 JAPAN

Accepted
March 22, 2000

To read the PDF file you will need Abobe Reader installed on your computer.