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Thoracoscopic Transthoracic Hepatectomy for Hepatocellular Carcinoma in Budd-Chiari Syndrome
Atsushi Takebe1, Masaya Nakano1, Katsuya Ami1
1Department of Surgery, Kindai University Hospital, Osaka, Japan.
Insights
Budd-Chiari syndrome (BCS) patients with liver cancer (hepatocellular carcinoma, HCC) can be treated with thoracoscopic transthoracic hepatectomy (TTH). This minimally invasive surgery is a viable option for high-risk BCS patients.
Area of Science:
- Hepatobiliary surgery
- Interventional oncology
- Vascular surgery
Background:
- Budd-Chiari syndrome (BCS) is a rare condition characterized by hepatic venous outflow obstruction, leading to liver congestion and portal hypertension.
- Hepatocellular carcinoma (HCC) incidence is notably higher in patients with BCS.
- Management of HCC in BCS patients requires careful consideration of hemodynamic status and minimally invasive surgical options.
Observation:
- An 88-year-old female patient with BCS presented with a hepatic tumor in liver segment 8.
- Preoperative hemodynamic assessment using angiography was performed.
- A thoracoscopic transthoracic hepatectomy (TTH) was chosen as the surgical approach.
Findings:
- Thoracoscopic transthoracic hepatectomy (TTH) was successfully performed for HCC in a BCS patient.
- The procedure was minimally invasive and guided by detailed hemodynamic evaluation.
- This approach was feasible and effective in managing the complex case.
Implications:
- Thoracoscopic transthoracic hepatectomy (TTH) offers a potential minimally invasive solution for HCC in high-risk patients, including those with BCS.
- Hemodynamic assessment is crucial for selecting appropriate surgical strategies in BCS patients with HCC.
- This case highlights the adaptability of advanced surgical techniques for challenging oncological conditions.
Abstract:
Budd-Chiari syndrome (BCS), caused by venous outflow obstruction, results in hepatic congestion and portal hypertension. BCS is also associated with a relatively high incidence of hepatocellular carcinoma (HCC). Selecting a minimally invasive approach based on hemodynamic assessment for the management of HCC arising from BCS is essential. A hepatic tumor located in liver segment 8 region was identified in an 88-year-old female patient with BCS. Following a detailed preoperative hemodynamic evaluation using angiography, a thoracoscopic transthoracic hepatectomy (TTH) was successfully performed. TTH may represent a feasible and effective surgical option for HCC in high-risk patients, including those with BCS.
