臨床外科77巻3号

2022年03月発行

臨床報告

術前のTAEにより安全に肝切除を施行した巨大肝左葉血管腫の1例

著者： 長田圭司¹ 中村公治郎¹ 岩﨑純治¹ 畑俊行¹ 伊丹淳¹ 京極高久¹

所属機関： ¹神戸市立西神戸医療センター外科

ページ範囲：P.367 - P.372

要旨
肝血管腫は比較的頻度の高い肝良性腫瘍である．10 cmを超える症例では破裂や腫瘍内出血など重篤な合併症を生じる危険性があるため，外科的切除の適応があると報告されている．症例は40代，女性．肝左葉の巨大血管腫に対し経過観察をしていたが，血管腫の増大傾向（最大径18 cm）を認めたため肝左葉切除術を施行した．手術前日に術中出血コントロール目的で選択的肝動脈塞栓療法（transcatheter arterial embolization：TAE）を行った．術中所見では肝血管腫の緊満感は消失していた．術中出血量は914 gであり，巨大肝血管腫に対し輸血することなく安全に摘出した．術前にTAEを行うことで術中出血のコントロールが可能となり，巨大肝血管腫に対する安全な治療戦略となりうる．

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