|Budget Amount *help
¥2,200,000 (Direct Cost : ¥2,200,000)
Fiscal Year 1997 : ¥1,200,000 (Direct Cost : ¥1,200,000)
Fiscal Year 1996 : ¥1,000,000 (Direct Cost : ¥1,000,000)
Purpose : To minimize complication of preoperative portal venous embolization, we newly divised a transumbilical portal venous embolization, TUPE.
Method : TUPE was applicated for one case of gallbladder cancer. The case was 46year old femail. Following the percutaneous transhepatic biliary drainage, the liver function was evaluated. Her liver function was almost normal. Hoever, to protect postoperative liver failure, the portal venous embolozation was performed preoperatively. Under the general anethesia.a balloon catheter for portal embolization was inserted per round hepatic ligament under the gudiwire guidance, The hepatic right lobe portal branch for resection was emblized using a embolic agent. The agent was composed with gel fom powder 2g, thrombin powder 5000 units, , and urografin 40ml/ Hepatic compensatory hypertrophy was caliculated by CT volumetry following embolization.
Result : Followng the TUPE,the liver volume of left lobe was improved from 30% to 46.6%. Therefore, radical extensive hapatic resection with gallbladder, bile duct resectioon, and lumph nodes dissection were carrried out safely.
Conclusion : We could applicated a TUPE safely only in one case of gallbladder cancer. The preperative TUPE therapy should become common to improve operative safety and the prognosis for patients of hepatobiliary malignancies who must undergo extensive hepatic resection.