[A Case of Intrahepatic Cholangiocarcinoma Treated with Extended Right Hepatectomy with Partial Resection of the Inferior Vena Cava Following Laparoscopic Portal Vein Ligation]

作者：Aiyama T, Kakisaka T, Yamamoto Y, Shichi S, Fujii Y, Fujiyoshi S, Nagatsu A, Kawamura N, Watanabe M, Goto R, Taketomi A · 发表于：Gan to kagaku ryoho. Cancer & chemotherapy · 年份：2025 · 研究领域：Portal Vein、Vena Cava, Inferior、Cholangiocarcinoma、Bile Duct Neoplasms、Humans、Female、Middle Aged、Hepatectomy、Laparoscopy、Ligation

INTRODUCTION: Portal vein embolization(PVE)is a preoperative procedure that requires contrast media, making it contraindicated in patients with a history of contrast-induced anaphylaxis. We report a case of intrahepatic cholangiocarcinoma (ICC)in which laparoscopic right portal vein ligation(PVL)was performed as an alternative to PVE due to this contraindication. CASE: A 60-year-old woman was found to have a liver tumor during a health checkup. Further evaluation led to a diagnosis of ICC. The tumor was in close contact with the right and middle hepatic veins and the inferior vena cava(IVC) and showed enlarged hilar and para-aortic lymph nodes(#16b1). Surgery was initially deemed unfeasible at another hospital, and systemic chemotherapy(GEM+CDDP+durvalumab)was initiated, maintaining stable disease for approximately 1 year. She was referred for potential conversion surgery. Although PVE was indicated, it was contraindicated due to a history of contrast anaphylaxis. Therefore, laparoscopic right PVL was performed instead. On postoperative day 26, extended right hepatectomy with partial IVC resection, cholecystectomy, and lymphadenectomy(including #16b1 int & lat)was performed. Aside from autosensitization dermatitis, her postoperative course was uneventful, and she was discharged on day 17. CONCLUSION: Laparoscopic PVL is a safe and effective alternative to PVE in patients with contrast contraindications.