[Transarterial segmental hepatic chemo-embolization in patients with hepatocellular carcinoma]

We can administer a Lipiodol-adriamycin emulsion transarterially into the portal vein, because more than a certain amount of Lipiodol injected into the hepatic artery enters the portal vein through arterioportal communications without arterioportal shunting. When Gelfoam embolization is followed by portal venous administration of this emulsion, hepatic chemoembolization is performed from both artery and portal vein simultaneously. But this chemoembolization must be in a limited area of the liver, since such treatment of the whole liver is lethal. We encountered a segmental hepatic chemoembolization in four patients with hepatocellular carcinoma by the catheterization of a hepatic segmental artery. In two cases operated after segmental chemoembolization, complete necrosis was certified in the main tumor and daughter nodules. Hepatic segmental atrophy and infarctions were also noted in the treated segment. In two non-operated cases, hepatic segmental atrophy and excellent antitumor effects were demonstrated by CT and radioisotope liver scan. Thus, we call this treatment "transarterial partial hepatectomy".