A case report of pure laparoscopic hepatectomy for Fontan procedure-related liver cancer: From the viewpoint of liver parenchymal dissection in Fontan circulation

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  • Fontan associated liver disease（FALD）関連肝癌に対しての腹腔鏡肝切除の1例―Fontan循環における肝離断対策―
  • Fontan associated liver disease(FALD)カンレン カンガン ニ タイシテ ノ フククウキョウ カン セツジョ ノ 1レイ : Fontan ジュンカン ニ オケル カンリダンタイサク

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Abstract

<p>The patient was a 31-year-old man who had undergone the Fontan Procedure for a single right ventricle at 3 years. A liver mass in segment 3 grew in size (23 mm in diameter) and alpha-fetoprotein concentration, raising the possibility of Fontan procedure-related liver cancer (FRLC). Laparoscopic partial liver resection was performed. Laparoscopic surgery is generally thought to be harmful for Fontan circulation patents with high central venous pressure (CVP). Several studies have recommended managing fluid administration to maintain low CVP, stopping positive end expiratory pressure, and decreasing airway pressure to avoid these situations. In the case of uncontrollable CVP despite several measures, a laparotomy may be recommended. Therefore, some indications of laparoscopic hepatectomy for FRLC should be necessary. We should collect data on FRLC patients by creating a large-scale, nationwide database.</p>

Journal

  • Kanzo

    Kanzo 64 (1), 18-25, 2023-01-01

    The Japan Society of Hepatology

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