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Treatment of colorectal liver metastasis with biliary and portal vein tumor thrombi by hepatopancreatoduodenectomy

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Journal of Hepato-Biliary-Pancreatic Surgery


We present a case of a large colorectal liver metastasis with portal vein and biliary tumor thrombi and duodenal and jejunal direct invasion that required hepatopancreatoduodenectomy. A 38-year-old woman presented to her local hospital with right back pain and jaundice. She had undergone transverse colectomy and limited liver resection for transverse colon cancer with a synchronous liver metastasis in September 1991, and low anterior resection for rectal carcinoma in January 1996. She was diagnosed as having colorectal liver metastasis and was referred to our hospital for possible surgery. Radiologic and endoscopic examinations revealed a large liver tumor occupying the right lobe, biliary dilation in the left lateral section, and a portal vein tumor thrombus. Invasion of the inferior vena cava and the right renal vein were also suspected. Intraoperative findings revealed a large liver tumor that occupied the right lobe and invaded the duodenum and jejunum. The tumor was resected successfully by right trisectionectomy, caudate lobectomy, pancreatoduodenectomy, partial resection of the jejunum, and combined portal vein resection and reconstruction. The inferior vena cava, right kidney, and renal vein could be detached from the tumor. The patient has enjoyed an active life without recurrence for 2 years since the operation.

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  1. S Nakamura S Suzuki H Konno (1999) ArticleTitleResection of hepatic metastases of colorectal carcinoma: 20 years’ experience J Hepatobiliary Pancreat Surg 6 16–22 Occurrence Handle10436233 Occurrence Handle1:STN:280:DyaK1MzmslOltQ%3D%3D Occurrence Handle10.1007/s005340050079

    Article  PubMed  CAS  Google Scholar 

  2. M Minagawa M Makuuchi G Torzilli T Takayama S Kawasaki T Kosuge et al. (2000) ArticleTitleExtension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results Ann Surg 231 487–99 Occurrence Handle10749608 Occurrence Handle1:STN:280:DC%2BD3c3htlaisA%3D%3D Occurrence Handle10.1097/00000658-200004000-00006

    Article  PubMed  CAS  Google Scholar 

  3. N Kokudo K Tada M Seki H Ohta K Azekura M Ueno et al. (2001) ArticleTitleAnatomical major resection versus nonanatomical limited resection for liver metastases from colorectal carcinoma Am J Surg 181 153–9 Occurrence Handle11425058 Occurrence Handle1:STN:280:DC%2BD3MzmtlGgsA%3D%3D Occurrence Handle10.1016/S0002-9610(00)00560-2

    Article  PubMed  CAS  Google Scholar 

  4. G Belli A D’Agostino F Ciciliano C Fantini N Russolillo A Belli (2002) ArticleTitleLiver resection for hepatic metastases: 15 years of experience J Hepatobiliary Pancreat Surg 9 607–13 Occurrence Handle12541048 Occurrence Handle10.1007/s005340200082

    Article  PubMed  Google Scholar 

  5. J Scheele R Stang A Althendorf-Hofmann M Paul (1995) ArticleTitleResection of colorectal liver metastases World J Surg 19 59–71 Occurrence Handle7740812 Occurrence Handle1:STN:280:ByqB2Mbjs1E%3D Occurrence Handle10.1007/BF00316981

    Article  PubMed  CAS  Google Scholar 

  6. K Okano J Yamamoto Y Moriya T Akasu T Kosuge M Sakamoto et al. (1999) ArticleTitleMacroscopic intrabiliary growth of liver metastases from colorectal cancer Surgery 126 829–34 Occurrence Handle10568181 Occurrence Handle1:STN:280:DC%2BD3c%2FjsVWktA%3D%3D

    PubMed  CAS  Google Scholar 

  7. R Izumi K Shimizu T Ii M Yagi O Matsui A Nonomura et al. (1994) ArticleTitlePrognostic factors of hepatocellular carcinoma in patients undergoing hepatic resection Gastroenterology 106 720–7 Occurrence Handle8119543 Occurrence Handle1:STN:280:ByuC28vkvFQ%3D

    PubMed  CAS  Google Scholar 

  8. K Tada N Kokudo M Seki M Ueno K Azekura H Ohta et al. (2003) ArticleTitleHepatic resection for colorectal metastasis with macroscopic tumor thrombus in the portal vein World J Surg 27 299–303 Occurrence Handle12607055 Occurrence Handle10.1007/s00268-002-6716-7

    Article  PubMed  Google Scholar 

  9. J Yamamoto K Sugihara T Kosuge T Takayama K Shimada S Yamasaki et al. (1995) ArticleTitlePathologic support for limited hepatectomy in the treatment of liver metastases from colorectal cancer Ann Surg 221 74–8 Occurrence Handle7826164 Occurrence Handle1:STN:280:ByqC38nnt10%3D

    PubMed  CAS  Google Scholar 

  10. Y Nimura N Hayakawa J Kamiya S Maeda S Kondo A Yasui et al. (1991) ArticleTitleHepatopancreatoduodenctomy for advanced carcinoma of the biliary tract Hepatogastroenterology 38 170–5 Occurrence Handle1649788 Occurrence Handle1:STN:280:By6A3M%2Fgtlc%3D

    PubMed  CAS  Google Scholar 

  11. G Giordano L Gnetti M Milione D Piccolo P Soliani (2005) ArticleTitleSerous psammocarcinoma of the ovary: a case report and review of literature Gynecol Oncol 96 259–62 Occurrence Handle15589614 Occurrence Handle10.1016/j.ygyno.2004.09.054

    Article  PubMed  Google Scholar 

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Sugiura, T., Nagino, M., Ebata, T. et al. Treatment of colorectal liver metastasis with biliary and portal vein tumor thrombi by hepatopancreatoduodenectomy. J Hepatobiliary Pancreat Surg 13, 256–259 (2006).

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