Laparoscopic associating liver tourniquet and portal ligation combined rescue transhepatic arterial embolization for staged hepatectomy: A case report

Staged hepatectomy is an important surgical method for large hepatocellular carcinoma (HCC). However, the insufficient future liver remnant (FLR) is still the major barrier in stage II hepatectomy. We herein reported a case of laparoscopic associating liver tourniquet and portal ligation combined re...

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Bibliographic Details
Published in:Medicine (Baltimore) 2017-10, Vol.96 (43), p.e8378-e8378
Main Authors: Xu, Jian, Lu, Xiangyu, Zhang, Yu, Yang, Hongji, Yu, Xiaojiong
Format: Article
Language:English
Subjects:
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - surgery
Clinical Case Report
Embolization, Therapeutic - instrumentation
Embolization, Therapeutic - methods
Hepatectomy - instrumentation
Hepatectomy - methods
Humans
Laparoscopy - instrumentation
Laparoscopy - methods
Ligation - instrumentation
Ligation - methods
Liver Cirrhosis - etiology
Liver Cirrhosis - surgery
Liver Neoplasms - complications
Liver Neoplasms - surgery
Male
Middle Aged
Neoplasm Recurrence, Local
Portal Vein - surgery
Postoperative Period
Tourniquets
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Summary:Staged hepatectomy is an important surgical method for large hepatocellular carcinoma (HCC). However, the insufficient future liver remnant (FLR) is still the major barrier in stage II hepatectomy. We herein reported a case of laparoscopic associating liver tourniquet and portal ligation combined rescue transhepatic arterial embolization (TAE) for staged hepatectomy. Laparoscopic associating liver tourniquet and portal ligation for staged hepatectomy (ALTPS) was performed for cirrhotic HCC in stage I. To stimulate the growth of FLR, a "rescue" TAE was initiated before stage II. HCC with hepatitis B cirrhosis. Two weeks later after TAE, the FLR achieved sufficient hypertrophy and stage II surgery was successfully performed. The patient was discharged 7 days after the second stage without serious complication. During the follow-up at postoperative 6 months, the patient underwent radiofrequency ablation, because contrast-enhanced ultrasonography showed 1 cm tumor recurrence in the remnant liver. Rescue TAE plays an important role to stimulate the increasing of FLR after ALTPS.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000008378