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Journal of Gastronenterology and Digestive Diseases
|
Volume 3
J u n e 2 5 - 2 6 , 2 0 1 8 | D u b l i n , I r e l a n d
GASTROENTEROLOGY
International Conference on
Iulian-Andrei Gilca et al., J Gastroenterol Dig Dis 2018, Volume 3
ANATOMICAL LIVER RESECTION FOR
INITIALLY UNRESECTABLE GIANT
HEPATOCELLULAR CARCINOMA IN
ELDERLY PATIENT: A CASE REPORT
Iulian-Andrei Gilca, L Mosoia, D Pescaru Th Artenie, A Dima,
C Mitru
and
V Dumitrascu
Central Military Emergency University Hospital, Roamania
Background:
Hepatocellular carcinoma (HCC) is less common in non-
cirrhotic 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 Bucha-
rest. 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.
gilcaiulian@gmail.comBIOGRAPHY