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ID 44826
本文ファイル
著者
Imaoka, Yuki
Ohira, Masahiro
Kuroda, Shintaro
Ishiyama, Kohei
Kobayashi, Tsuyoshi 大学院医歯薬保健学研究科(医) 広大研究者総覧
Ishikawa, Masaki
Awai, Kazuo 大学院医歯薬保健学研究科(医) 広大研究者総覧
Ohdan, Hideki 大学院医歯薬保健学研究科(医) 広大研究者総覧
キーワード
Intraoperative angiography
Hybrid operation room
Hepatic encephalopathy
NDC
医学
抄録(英)
Regarding the treatment for a portosystemic shunt, surgical or interventional radiological closure of the shunt was established. Interventional radiology including balloon-occluded retrograde transvenous obliteration can worsen portal hypertension and create a large thrombus close to the major venous system in the case of a huge portosystemic shunt. In contrast, it is also difficult to treat some cases through surgery alone when huge complicated shunts exist very deep in the body. Herein, we report a successful case of surgical shunt ligation for portosystemic encephalopathy in a hybrid operation room that enabled intraoperative angiography and computed tomography. A 62-year-old woman with chronic hepatitis C was referred to our hospital due to high levels of serum ammonia and hepatic encephalopathy. She had a massive, complicated portosystemic shunt from the inferior mesenteric vein to the left renal vein but did not have esophageal or gastric varices. It was difficult to occlude the portosystemic shunt by interventional radiologic techniques because the shunt had an extremely large amount of blood flow and many collateral routes. We performed the shunt ligation in the hybrid operation room. Intraoperative angiography provided detailed information about the portosystemic shunt, such as direction or volume of blood flow and collateral routes in real time. Her encephalopathy disappeared completely and she remains healthy with improved liver functional reserve to date. In conclusion, this is a successful case of a hybrid operation for an extremely large and complicated portosystemic shunt, providing for intraoperative angiography as a safe and reliable surgical treatment for portosystemic encephalopathy in patients with liver cirrhosis.
掲載誌名
Hiroshima Journal of Medical Sciences
66巻
1号
開始ページ
11
終了ページ
15
出版年月日
2017-03
出版者
Hiroshima University Medical Press
ISSN
0018-2052
NCID
言語
英語
NII資源タイプ
紀要論文
広大資料タイプ
学内刊行物(紀要等)
DCMIタイプ
text
フォーマット
application/pdf
著者版フラグ
publisher
権利情報
Copyright (c) 2017 Hiroshima University Medical Press
部局名
医歯薬保健学研究科
病院
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