Laparoscopic Right Portal Vein Ligation for Metastatic Liver Tumors

In the case of an extended hepatectomy, percutaneous transhepatic portal vein embolization (PTPE) is necessary for a metastatic liver tumor, in order to enlarge the remnant liver. In a case with a giant tumor occuping the right lobe, PTPE would unavoidably injury the remnant liver. There is a method to perform portal vein branch ligation at primary operation especially in a case with simultaneously metastatic liver tumors. But, because this technique may cause extensive adhesion of the hepato-duodenal ligament, surgical treatment might be difficult around the hepatic hilar region at hepaectomy.
We approach laparoscopically a right portal vein ligation (LRPL). We report one case of LRPL. A patient was a 43-year-old woman with both a descending colon cancer and a giant metastatic liver tumor in the right lobe. After the primary operation which was laparoscopic colectomy, she underwent chemotherapy. Then we planned extended right lobectomy og the liver, but the remnant liver volume was 28%. Then we performed LRPL and the follow-up CT showed remnant liver hypertrophy (39%). Operation time was 70 minutes and the hospital stay after LRPL was 4 days. We performed right lobectomy by laparoscopic-assisted surgery smoothly.
LRPL is feasible technique as one of therapy in a multidisciplinary therapy for colorectal cancer.
We will accumulate more cases and examine the results of this method.


Session: Poster

Program Number: P388

« Return to SAGES 2009 abstract archive