Abstract
Portal angioscopy was performed during hepatectomy for the intravascular observation of the portal vein in 12 patients with hepatocellular carcinoma and in 4 patients with metastatic liver tumor. The efficacy and the limitations of operative portal angioscopy for clinical use were investigated based on our clinical experience. Blood in the portal vein was completely diverted by an infusion of heparinized Hartman solution through a channel of the angioscope at a volume of 12 ml/min. A decrease of this infusion flow at 5 ml/min did not lead to any blood regurgitation. However, an infusion volume at less than 3 ml/min resulted in opacification of the optical view. The angioscope was easily inserted into the third-order portal branch using an angulation system. Both observation and removal of tumor thrombus was successfully performed angioscoplcally in 6 patients with hepatocellular cacinoma bearing a portal tumor thrombus (Vp3). Though operative portal angioscopy is designed to observe the intravascular space of the portal vein, further technical improvements are desirable before this technique becomes a routine procedure.
