%0 Journal Article
%T Anatomical liver segmentectomy 2 for combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in segment 2 portal branch
%A Hiromichi Ishii
%A Takuma Kobayashi
%A Michihiro Kudou
%A Masumi Nishimura
%A Atsushi Toma
%A Kenji Nakamura
%A Takeshi Mazaki
%A Tsuyoshi Itoh
%J World Journal of Surgical Oncology
%D 2012
%I BioMed Central
%R 10.1186/1477-7819-10-22
%X A 52-year-old man was preoperatively diagnosed with hepatocellular carcinoma in segment 2 with tumor thrombus in the segment 2 portal branch. Anatomical liver segmentectomy 2, including separation of the hepatic arteries, portal veins, and bile duct, enabled us to remove the tumor and portal thrombus completely. Modified selective hepatic vascular exclusion, which combines extrahepatic control of the left and middle hepatic veins with occlusion of left hemihepatic inflow, was used to reduce blood loss. A pathological examination revealed combined hepatocellular carcinoma and cholangiocarcinoma with tumor thrombus in the segment 2 portal branch. No postoperative liver failure occurred, and remnant liver function was adequate.The separation method of the hepatic arteries, portal veins, and bile duct is safe and feasible for a liver cancer patient with portal vein tumor thrombus. Modified selective hepatic vascular exclusion was useful to control bleeding during liver transection. Anatomical liver segmentectomy 2 using these procedures should be considered for a patient with a liver tumor located at segment 2 arising from a damaged liver.Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an uncommon primary liver cancer subtype [1] and is difficult to correctly diagnose preoperatively. Most patients with cHCC-CC are preoperatively misdiagnosed with hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) including our present patient. Hepatic resection leads to improved survival in patients with cHCC-CC [2-5] or HCC with portal vein tumor thrombus (PVTT) [6,7]. In patients with liver cirrhosis, extended liver resection for liver cancer is sometimes not feasible because of decreased liver functional reserve; therefore, anatomical segmentectomy or limited non-anatomical hepatectomy must be performed. We herein report an anatomical liver segmentectomy 2 surgical procedure successfully performed for a patient with cHCC-CC and PVTT in the segment 2 porta
%K anatomical segmentectomy 2
%K portal vein tumor thrombus
%K combined hepatocellular carcinoma and cholangiocarcinoma
%K modified selective hepatic vascular exclusion
%U http://www.wjso.com/content/10/1/22