Abstract
This paper presents a successful treatment of a 99% stenosis of the portal vein due to invasion of cholangiocellular carcinoma in a 72-year-old woman, with intraoperative radiation and dilatation of the protal vein by an expandable metallic stent (EMS) with partial excision of the colon. Monitoring by imaging method, a Gianturco-Roesch biliary Z-stent with a diameter of 10mm was embeded at the stenosed site, and 20 Gy radiation was given to the porta hepatis intraoperatively. The stenosis was as narrow as the guide wire barely passed through, but the stent was able to dilate. Postoperative course was uneventful. The portal vein was dilated to 7mm in diameter (70% stenosis). The significance of this case lies in the use of a metallic stent to dilate the malignant stenosis of the portal vein. We recommend the use of this metallic stent for the patients who are not possible candiates for operation and have a very poor prognosis.
