ANATOMICAL LIVER RESECTION FOR INITIALLY UNRESECTABLE GIANT HEPATOCELLULAR CARCINOMA IN ELDERLY PATIENT: A CASE REPORT
International Conference on Gastroenterology
June 25-26, 2018 | Dublin, Ireland
Iulian-Andrei Gilca, L Mosoia, D Pescaru Th Artenie, A Dima, C Mitru and V Dumitrascu
Central Military Emergency University Hospital, Roamania
Scientific Tracks Abstracts : J Gastroenterol Dig Dis
Background: Hepatocellular carcinoma (HCC) is less common in noncirrhotic livers. Resectability of the tumour, needs sufficient liver remnant and this process can be achieved mainly to increase the future liver remnants in patients through hypertrophy. Materials & Methods: In this report, we present a 75 years old patient who came to our attention one month after the initial ultrasound with palpable hepatomegaly. The CT showed a hyper vascularized solitary liver lesion measuring 20/18 cm originated from right hepatic lobe, with small for size left hemi liver at volumetry. Laboratory data showed normal liver function and hepatitis B and C serologies were negative. Serum tumour markers including CEA, CA 12.5, CA 19.9 were within normal range while AFP was elevated, >500. Due to the insufficient future liver remnant, we performed right portal vein ligation (PVL) in the first instance, to convert the unresectable tumour to resectable for potential cure. Results: We record the success of PVL with compensatory hypertrophy in the left liver, seen at seven weeks after PVL. The patient underwent planned laparotomy and right hepatectomy with uneventfully postoperative follow-up and discharge in day nine. Conclusion: The case presented, indicates that surgical resection for giant HCC is possible in elderly patients, even if initially, the future liver remnant does not allow surgical therapy.
Iulian-Andrei Gilca is a surgical trainee in his third year of general surgery residency program in the First Department of Surgery at Central Military Emergency University Hospital Bucharest. He graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, year of 2015. Since he started training to become a general surgeon, He was fascinated by the hepatobiliary, pancreatic surgery and oncologic surgery and focused on acquiring expertise in this fields. His current interests encompasses surgical conditions of the gastrointestinal tract with a main concern on liver transplant surgery. Email:[email protected]