Abstract
Hepatic resection in nonalcoholic steatohepatitis (NASH) requires a cautious preoperative evaluation and appropriate resection due to possibly decreased hepatic function reserve caused by NASH. Our case involved a 71-year-old woman with elevated hepatobiliary enzyme and diagnosed with hepatic hilar duct cancer extending from the confluence of the right and left hepatic ducts to the right hepatic duct. Her history of diabetes, hyperlipidemia, and fatty liver led us to suspect NASH. Hepatic function reserve was considered sufficient because ICGR15 and HH15 and LHL15 of 99mTc-GSA scintigraphy were normal. An increased estimated hepatic function reserve of 39.1% was obtained by 99mTc-GSA scintigraphy following portal vein embolization, and extended right lobectomy was done. No signs of postoperative hepatic failure were seen and the patient has progressed well. Histopathological findings confirmed a diagnosis of NASH, suggesting that surgical methods and evaluating hepatic function reserve as in cases of liver cirrhosis which center around ICGR15 and 99mTc-GCA scintigraphy are useful in cases of NASH.
