Rupture of the hepatic artery after left hemihepatectomy for hilar bile duct carcinoma |
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Authors: | Hiromu Tanaka Kazuhiro Hirohashi Yasuhiro Ohta Eiji Kimura Taichi Shuto Akishige Kanazawa Takatsugu Yamamoto and Hiroaki Kinoshita |
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Institution: | (1) Second Department of Surgery, Osaka City University Medical School, 1-5-7 Asahimachi, Abeno-ku, 545 Osaka, Japan;(2) Second Department of Pathology, Osaka City University Medical School, 1-5-7 Asahimachi, Abeno-ku, 545 Osaka, Japan;(3) Department of Surgery, Ashihara Hospital, 2-13-19 Naniwahigashi, Naniwa-ku, 556 Osaka, Japan;(4) Department of Cardiovascular Surgery, Osaka City General Hospital, 2-13-22 Miyakojima Hondori, Miyakojima-ku, 534 Osaka, Japan |
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Abstract: | Hilar bile duct carcinoma has a poor prognosis, but this has been improved in recent years by an aggressive surgical approach.
We treated a 73-year-old woman who had obstructive jaundice due to bile duct carcinoma at the hepatic hilum. The jaundice
decreased after percutaneous transhepatic biliary drainage. The tumor was resected with the left and caudate lobe of the liver
and a part of portal vein. The right hepatic artery was located behind the common hepatic duct, and was suspected to be invaded
by the tumor. We dissected the tumor from the arterial wall without carrying out combined resection of the hepatic artery.
On the 6th postoperative day, the hepatic artery ruptured and the patient suffered hypovolemic shock. Resection of the hepatic
artery and reconstruction were done, but the patient died 2 days later. Histological examination of the resected artery showed
that the tumor had been curatively removed by dissection and that no tumor remained at the arterial wall. The rupture of the
right hepatic artery was thought to have been caused by damage to the wall during the dissection procedure. |
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Keywords: | hepatic arterial rupture arterial reconstruction hilar bile duct carcinoma |
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