HIGUCHI Ryota    Department   School of Medicine(Yachiyo Medical Center), School of Medicine    Position   Assistant Professor
Article types	Case report
Language	English
Peer review	Peer reviewed
Title	A staged approach with initial tumor thrombectomy followed by hepatectomy for icteric-type hepatocellular carcinoma: A case report.
Journal	Formal name：International journal of surgery case reports Abbreviation：Int J Surg Case Rep ISSN code：22102612/22102612
Volume, Issue, Page	64,pp.1-5
Author and coauthor	Yazawa Takehisa, Ohta Takehiro, Ariizumi Shun-Ichi, Takahashi Yutaka, Higuchi Ryota, Yamamoto Masakazu
Publication date	2019
Summary	INTRODUCTION:Biliary drainage for patients with icteric-type hepatocellular carcinoma (HCC) is sometimes difficult, because the drainage tube makes contact with the tumor thrombus (TT) and effective drainage cannot be achieved due to hemobilia.PRESENTATION OF CASE:We performed endoscopic naso-biliary drainage for an icteric-type HCC patient; however, the serum bilirubin level was not decreased due to bleeding from the TT. Therefore, we performed tumor thrombectomy in the bile duct and transection of the right hepatic bile duct prior to right hepatectomy. After the first operation, the bilirubin level was decreased, and liver function was recovered so that the patient could undergo right hepatectomy 4 months after the first operation. The postoperative course was uneventful after the second operation and the patient was discharged from the hospital on the 30th postoperative day. The patient is well without recurrence 10 years after surgery.CONCLUSION:Biliary drainage is one of the key points for successful treatment of icteric-type HCC patients. A staged approach with initial tumor thrombectomy followed by hepatectomy should be considered as one of the options for icteric-type HCC.
DOI	10.1016/j.ijscr.2019.09.030
PMID	31585354