Direct observation and removal of a portal tumor thrombus were attempted in a patient with hepatocellular carcimona (HCC) bearing a tumor thrombus in the portal trunk (Vp3) using a fiberscope. A 63-year-old male was found to have HCC in the left hepatic lobe bearing a portal tumor thrombus, which caused a stenosis of the portal trunk. Prior to hepatectomy, the tumor thrombus in the portal trunk was direcly removed through portal trunk venotomy, and the residual tumor thrombus in the peripheral portal branches were fiberscopically removed using Fogarty balloon catheter and suction. Though recurrence of a tumor in the liver was observed in a follow-up period, his prognosis seemed to be prolonged more than that of natural course.
This case might be an example indicating that surgical treatment became effective to prolong a prognosis of a patient with HCC bearing Vp3 and portal angioscopy seemed available in surgical operation.