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The clinical and experimental study on the operative procedure of removal of tumor thrombi in the hepatic vein and inferior vena cava in patients with hepatocellular carcinoma

Research Project

Project/Area Number 60480310
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field Digestive surgery
Research InstitutionSchool of Medicine, Keio University

Principal Investigator

TSUZUKI Toshiharu  Department of Surgery, Keio University School of Medicine, 医学部, 助教授 (80051192)

Co-Investigator(Kenkyū-buntansha) OZAWA Iwao  Department of Surgery, Keio University School of Medicine, 医学部, 助手 (10152464)
SUGIOKA Atsushi  Department of Surgery, Keio University School of Medicine, 医学部, 助手 (20171150)
IIDA Shuhei  Department of Surgery, Keio University School of Medicine, 医学部, 助手 (00101973)
Project Period (FY) 1985 – 1986
Project Status Completed (Fiscal Year 1986)
Budget Amount *help
¥6,400,000 (Direct Cost: ¥6,400,000)
Fiscal Year 1986: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1985: ¥5,800,000 (Direct Cost: ¥5,800,000)
KeywordsHepatocellular carcinoma / Hepatic vein / Inferior vena cava / Tumor thrombi / 肝切除
Research Abstract

Hepatocellular carcinoma tends to spread through tumor thrombi in the portal vein, hepatic vein and inferior vena cava. Tumor thrombi in the portal vein can be removed without difficulty but tumor thrombi in the hepatic vein extending into the inferior vena cava can only be extracted by vascular exclusion technique which consisted of clamping of hepatic artery, portal vein, infra-and supra hepatic inferior vena cava. Two patients underwent this precedure. Right trisegmentectomy and removal of tumor thrombus in the right portal vein extending into the inferior vena cava was performed using vascular exclusion of 26 minutes duration. In another patient metastatic left suprarenal tumor with tumor thrombus extending from the left suprarenal vein into the inferior vena cava was extirpated with the use of vascular exclusion of 10 minutes duration. It was shown that vascular exclusion of more than 20 minutes duration was followed by decrease in cardiac output, fall in blood pressure with elevation of peripheral vascular resistance. This was due to bleeding which was the result of congestion of the remnant liver. To establish the simple and safe operative procedure, an experimental study was carried out. Thirty eight dogs were used to clarify the usefulness of bypass procedure which diverts blood in the portal vein or inferior vena cava or both into the superior vena cava. Twenty three dogs undergoing vascular exclusion of 45 minutes duration were attended by high operative mortality. Thus, the second series of experiment was performed in 15 dogs with the use of vascular exclusion of 30 minutes. It was shown that dogs having bypass of the portal vein or portal vein and inferior vena cava underwent less remarkable changes in circulatory dynamics than that of dogs having no bypass. This result suggests feasiblity of bypass procedure.

Report

(1 results)
  • 1986 Final Research Report Summary
  • Research Products

    (11 results)

All Other

All Publications (11 results)

  • [Publications] 都築俊治: 肝胆膵. 14. 375-382 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] 都築俊治: 胆と膵. 8. 133-140 (1987)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] 都築俊治: 手術. 40. 1941-1948 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] 都築俊治: 医学のあゆみ. 136. 1190-1195 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] Tsuzuki T: Cancer. 55. 2835-2838 (1985)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] 都築俊治: 外科治療. 52. 197-204 (1985)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] Tsuzuki T et al: "Results of surgical treatment of cancer of the main hepatic duct junction" KAN・TAN・SUI (Japan). 14. 375-382 (1987)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] Tsuzuki T et al: "Surgical treatment of cancer of the bile ducts; operative procedures and results" The Biliary Tract & Pancreas. 8. 133-140 (1987)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] Tsuzuki T et al: "The surgical treatment for primary and metastatic carcinoma of the liver" Igaku No Ayumi. 136. 1190-1195 (1986)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] Tsuzuki T et al: "Long-term survival of patients with hepatocellular carcinoma combined with liver cirrhosis. Report of two patients." Cancer. 55. 2835-2838 (1985)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1986 Final Research Report Summary
  • [Publications] Tsuzuki T et al: "Extensive operations for cancer of the bile ducts and gallbladder" Surgical Therapy. 52. 197-204 (1985)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1986 Final Research Report Summary

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Published: 1987-03-31   Modified: 2016-04-21  

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