Successful resection,using pancreas-sparing duodenectomy,of extrahepatically growing hepatocellular carcinoma associated with direct duodenal invasion |
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Authors: | Cho Akihiro Ryu Munemasa Ochiai Takenori |
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Institution: | (1) Department of Surgery, Chiba Prefectural Sawara Hospital, 2285 I Sawara, Chiba 287-0003, Japan, JP;(2) Second Department of Surgery, Chiba University of Medicine, Chiba, Japan, JP |
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Abstract: | A 50-year-old man with extrahepatically growing hepatocellular carcinoma (HCC) associated with direct duodenal invasion underwent
a right posterior segmentectomy associated with pancreas-sparing duodenectomy. Neither periduodenal lymph-node metastasis
nor pancreatic invasion was detected, thus we separated the supra-ampullary duodenum from the pancreatic head and performed
pancreas-sparing supra-ampullary duodenectomy. The resected specimen was observed to be a centrally necrotic tumor that had
infiltrated the duodenal wall, resulting in exposure of the lumen. Pathology examination revealed that the tumor consisted
of poorly differentiated HCC, which had extensively infiltrated the mucosa of the duodenum. Gastrointestinal tract involvement
in patients with HCC is rare, and pancreas-sparing duodenectomy is a safe and effective treatment for patients with HCC associated
with direct duodenal invasion.
Received: December 31, 2001 / Accepted: April 14, 2002 |
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Keywords: | Hepatocellular carcinoma Extrahepatic growth Direct duodenal invasion Pancreas-sparing duodenectomy |
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