2007 Volume 18 Issue 1 Pages 27-31
A 68-year-old woman was admitted to our hospital under a diagnosis of melena due to cavernous transformation of the hepatic hilar lesion. Choledochojejunostomy was performed for choledochal cystoma over 30 years ago, and she sufferd from chronic pancreatitis for a long time. Portal vein thrombosis had been pointed out for 3 years, although her liver function was normal. Therefore, it was thought that portal vein thrombosis caused collateral circulation via lifted jejunal vein and made hepatic hilar cavernous transformation. We performed, at first, mosocaval shunt, but it was obstructed in 5 months. Therefore, with minimal laparotomy, we led a catheter from peripheral mesenteric vein to the feeding vein of cavernous transformation, and performed the transcatheter coil occulusion for the feeding vein. This combined therapy for hepatic hilar cavernous transformation, minimal laparotomy and endovascular surgery (EVS), was very effective and minimal invasive one.
