THE CLINICAL COURSE OF A CASE OF TUMOR EMBOLUS IN THE INTRAHEPATIC BILIARY TRACT WITH REFERENCE TO A DEVICE FOR THE LONG-TERM MAINTENANCE OF THE ROUTE FOR THE INSERTION OF CHOLANGIOSCOPE

Abstract

On a 52-year-old woman with an icteric type hepatoma a partial hepatecomy was carried out. Embolectomy was performed using the Fogarty's catheter through cholangioscope against the tumor embolus remaining in the intrahepatic bile duct. Furthemore intra-arterial administration of 20mg of MMC and surface irradiation of 5, 000rad with 60Co were carried out. These treatments seemed to be effective radiologically and endoscopically, for they changed immediately the surface of the mucous membrane to smooth scar. However, the degeneration was actually minimal and the tumor was not sensitive to these treatments when studied pathologically. We could follow the change of the radiological and endoscopic findings of the bile duct up to 6 months postoperatively. We also reported a special catheter made of sillicone effective for long-term maintenance of the route for the insertion of cholangioscope.