Two Cases of Liver Metastases with Biliary Invasion from Colorectal Cancer Which Were Successfully Treated by Laparoscopic Hepatectomy

Abstract

We report two cases of liver metastases from colorectal cancer with macroscopic intrabiliary invasion, which were successfully treated with laparoscopic hepatectomy. Case 1: An 84-year-old woman underwent low anterior resection for rectal cancer. Three years after the operation, CT revealed liver tumors, at segment 8, with dilatation of the intrahepatic bile ducts. The tumors were preoperatively diagnosed as metastases from rectal cancer with intrabiliary invasion, and hand assisted laparoscopic hepatic partial resection was performed. Case 2: A 65-year-old man underwent laparoscopic sigmoidectomy for sigmoid colon cancer. Three years after the operation, CT revealed a liver tumor, 30 mm at segment 7 and a low density area at segment 6 accompanied with partial biliary dilatation. The tumors were preoperatively diagnosed as metastases from sigmoid colon cancer with intrabiliary invasion, and pure laparoscopic hepatic partial resection was performed. In both cases, we confirmed the extent of biliary invasion of the tumors by intraoperative US. We confirmed negative the surgical margin of the bile duct by intraoperative frozen section analysis. Histologically, the tumors were confirmed to be liver metastases with biliary invasion from colorectal cancer.