Tetsuya KANEKO, Akimasa NAKAO, Hiroyuki SUGIMOTO

Department of Surgery II University of Nagoya Faculty of Medicine 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan

キーワード : Doppler ultrasonography, Hepatectomy, Hepatofugal flow, Portal vein

Hepatofugal portal blood flow after surgery other than portosystemic shunt procedures is reported to have grave prognostic significance. We experienced a rare case with good postoperative course after an extended right hepatic lobectomy for gallbladder cancer in spite of intrahepatic hepatofugal portal blood flow after surgery. In this patient, preoperative percutaneous transhepatic bile duct drainage was performed for obstructive jaundice. Percutaneous transhepatic portal embolization was also performed to increase the safety of major hepatectomy before surgery. An intrahepatic arterioportal shunt made by these interventional procedures was thought to induce intrahepatic reversed portal flow. In this patient, most of the intrahepatic portal blood flow was hepatofugal, but partial hepatopetal flow was preserved. Thus, preservation of partial hepatopetal flow contributed to the good postoperative course.