RESUMO
Preduodenal portal vein (PDPV) is a rare developmental anomaly. We recently encountered this anomaly in a 73-year-old woman who had gastric cancer and colonic cancer with liver metastasis. The PDPV was diagnosed preoperatively by computed tomography and angiography. To the best of our knowledge, there are only 19 adult cases reported in the world literature, with this additional case being reported here. In infants the anomaly has often been associated with duodenal obstruction, but in adults it is often symptomless. We discuss the disease process, embryology, diagnosis, association with other anomalies, and surgical treatment.
Assuntos
Obstrução Intestinal/etiologia , Veia Porta/anormalidades , Anormalidades Múltiplas , Idoso , Angiografia , Neoplasias do Colo/complicações , Neoplasias do Colo/cirurgia , Duodeno , Feminino , Humanos , Obstrução Intestinal/diagnóstico , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Obesidade/complicações , Veia Porta/diagnóstico por imagem , Embolia Pulmonar/etiologia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Out of 213 consecutive cases of colorectal cancer patients, 39 patients had liver metastasis (31 synchronous metastases and 8 metachronous metastases). One-and 3-year survivals of these patients with liver metastases were 46.5% and 30.1%, respectively. Twenty-four patients who were treated with intra-hepatic-arterial chemotherapy had better survival rates of 54.7% at 1 year, and 36.5% at 3 years than non-treated patients. Fifteen patients who underwent curative hepatic resection had better survival rates of 83.1% at 1 year, and 48.5% at 3 years than non-resected patients. Thirteen patients who underwent curative hepatic resection followed by intra-hepatic-arterial chemotherapy had good survival rates of 80.8% at 1 year, and 53.9% at 3 years. Seven patients who had multiple metastases to both lobes, were treated with intra-hepatic-arterial chemotherapy. These patients had a better survival rate of 22.9% at 1 year than non-treated patients.
Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/patologia , Bombas de Infusão Implantáveis , Neoplasias Hepáticas/tratamento farmacológico , Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Esquema de Medicação , Epirubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Hepatectomia , Artéria Hepática , Humanos , Infusões Intra-Arteriais , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , PrognósticoRESUMO
Laser therapy for bile duct stones, such as the non-contact beam treatment using continuous wave of Nd:YAG laser or contact beam treatment using ceramics rod, has been done in our institution from 1980. As a result, the ratio of complete lithotomy has been increased from 31/47 (66%) to 66/71 (93%). Recently, we had a opportunity to use the Lasertripter by Candera Corp., which was devised for urinary stones. It beams pulse wave to crush stones. The effectiveness of this new laser lithotripsy is different according to the kind of the stones, but it is better than that of conventional YAG laser. Furthermore, as this method can be used with thin fiberscope, this method is more effective to peripheral intrahepatic stones than YAG laser.