A Successful resected Case of Intrahepatic Cholangiocellular Carcinoma in Caudate Lobe

Hirofumi Shirakawa, Toshio Nakagohri, Naoto Gotohda, Shinichirou Takahashi, Masaru Konishi, Motohiro Kojima* and Taira Kinoshita

Department of Upper Abdominal Surgery and Department of Pathology*, National Cancer Center Hospital East

We report a case of rare curatively resected Intrahepatic cholangiocarcinoma of the caudate lobe. A 59-year-old man undergoing endoscopic retrograde biliary drainage for obstructive jaundice due to intrahepatic cholangiocarcinoma and admitted for further examination was found in ultrasonography, computed tomography, endoscpopic retrograde cholangiography, and angiography to have an irregular mass-forming tumor 4.5 cm in diameter. The tumor, located in the caudate lobe, had spread to the bilateral hepatic lobe. The right intrahepatic bile duct was markedly dilated and the right hepatic artery and the transverse portion of the left portal vein in the hilum were involved, although the left hepatic artery was intact. We conducted extended right hepatectomy with caudate lobectomy after percutaneous transhepatic portal vein embolization, concomitantly resecting the common bile duct, left portal vein, and right hepatic artery due to tumor involevement. Pathological findings showed moderately differentiated adenocarcinoma and negative resection margins of the liver parenchyma and left intrahepatic bile duct. A postoperative subphrenic abscess was treated by temporary percutaneous drainage. The man was discharged on postoperative day 40 and remains without recurrence in the 18 months since surgery.

Key words
Intrahepatic cholangiocarcinoma, caudate lobe, poral vein resection

Reprint requests
Hirofumi Shirakawa Department of Upper Abdominal Surgery, National Cancer Center Hospital East
6-5-1 Kashiwanoha, Kashiwa, 277-8577 JAPAN

Accepted
July 23, 2008

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