Abstract
A 72-year-old man was referred to our hospital after dilatation of the intrahepatic bile duct was detected on computed tomography for jaundice at a local hospital. He was given a diagnosis of Bismuth type Ⅲa hilar cholangiocarcinoma on further examination at our hospital. He had a past history of old myocardial infarction. Coronary angiography showed complete obstruction of the proximal of the right coronary artery, the middle of the left anterior descending coronary artery, the middle of the left circumflex coronary artery, and he was also given a diagnosis of triple-vessel disease. His heart function was class I according to the NYHA classification and the ejection fraction was 45%. Right and caudate lobectomy of the liver, and resection of the extrahepatic bile duct with intra-aortic balloon pumping was performed after bolus injection of heparin. His hemodynamic state was stable during the perioperative period. The pathological findings revealed gallbladder cancer. The postoperative course was uneventful and he was discharged on the 16th postoperative day.
