A Case of Hepatocellular Carcinoma Resected after Improvement of Liver Function by Balloon-Occluded Retrograde Transvenous Obliteration

Kazutoyo Morita¹⁾, Akinobu Taketomi¹⁾, Yo-ichi Yamashita¹⁾, Takasuke Fukuhara¹⁾, Hiroto Kayashima¹⁾, Yousuke Kuroda¹⁾²⁾, Shinji Itoh¹⁾, Kouzou Konishi¹⁾, Hirofumi Kawanaka¹⁾ and Yoshihiko Maehara¹⁾

Department of Surgery and Science¹⁾ and Department of Anatomic Pathology²⁾, Graduate School of Medical Sciences, Kyushu University

Hepatocellular carcinoma with liver cirrhosis is often unresectable due to liver dysfunction. A 82-year-old man had two hepatocellular carcinomas measuring 2.5 cm at S6 and 1 cm at S8 of the liver. Despite transcatheter arterial chemoembolization (TACE) for these carcinomas, local recurrence was seen at S6, TACE repeated, and local recurrence seen again. He had severe liver dysfunction (Child-Pugh 8; Grade B, and liver damage C) and a huge gastro-renal shunt. Balloon-occluded retrograde transvenous obliteration (B-RTO) was conducted to increase portal flow to the liver and improve liver function. After B-RTO, liver function improved to Child-Pugh 6; Grade A, and liver damage B. Partial hepatic resection (S6) was successful and the man was discharged on postoperative day 14 without postoperative complications. The obliteration of portosystemic shunt using B-RTO makes it possible to conduct hepatic resection for hepatocellular carcinoma in patients with severe liver dysfunction. This strategy is especially useful in the treatment of TACE resistant carcinoma.

Key words
hepatic resection, hepatocellular carcinoma, balloon-occluded retrograde transvenous obliteration (B-RTO)

Reprint requests
Kazutoyo Morita Department of Surgery and Science, Graduate School of Medical Siences, Kyushu University
3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 JAPAN

Accepted
October 29, 2007

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