제 IIIb형 간문부 담관암 환자에서 시행한 간실질 보존 수술로서의 S4a+S5 및 미상엽(S1) 간절제술
S4a+S5 with Caudate Lobe (S1) Resection as a Parenchyma-preserving Liver Resection for a Patient with Type IIIb Hilar Bile Duct Cancer
소속 상세정보
황신/Shin Hwang
문덕복/박은화/김명환/이영주/이승규/Deog Bok Moon/Eun Hwa Park/Myung Hwan Kim/Young Joo Lee/Sung Gyu Lee
KMID : 0371320030640060515
Abstract
The prognosis of hilar bile duct cancer has been improved by extensive curative resection, but massive hepatectomy can result in surgical and medical complications in high-risk patients. We report a case of type IIIb hilar bile duct cancer undergone
S4a+S5 with caudate lobe (S1) resection as a parenchyma-preserving hepatectomy. The operation was a modified type of Taj Mahal liver resection omitting parencymal transection between S4b and S8. Such an extent of hepatectomy combined with bile duct
resection made 3 right and 3 left intrahepatic segmental duct openings, which were reconstructed as a whole at each side of transection plane after ductoplasty. The patient recovered uneventfully. Although surgical technique for S4a+S5+S1 must be more
complex comparing with other anatomical hepatectomy, but it could be accepted as a safe curative resection for some selected patients with advanced hilar bile duct cancer, by which favorable recovery of the liver function may lead to prevention of
postoperative complications. Comprehension to the anatomy of the intrahepatic ducts is a prerequisite for S4a+S5+S1 resection, thus we discussed it in detail.
키워드
간문부 담관암; 타지마할 간절제술; 미상엽 절제; 근치적 절제; 실질보존 간절제; Hilar bile duct cancer; Taj Mahal liver resection; Caudate lobectomy; Curative resection; Parenchyma-preserving hepatectomy;
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