Evaluation of Hepatic Functional Reserve and Perioperative Course after Hepatectomy in a Case of Dubin-Johnson Syndrome

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  • HAYASHI Tomomi
    Department of Surgery, Kirishima Medical Center, Kirishima-shi
  • KADONO Jun
    Department of Surgery, Kirishima Medical Center, Kirishima-shi
  • INOUE Maki
    Department of Surgery, Kirishima Medical Center, Kirishima-shi
  • SAKAMOTO Akihiko
    Department of Surgery, Kirishima Medical Center, Kirishima-shi
  • HUTAWATARI Hisatomo
    Department of Surgery, Kirishima Medical Center, Kirishima-shi
  • HIRAKI Tsubasa
    Department of Pathology, Kagoshima University Graduate School of Medical
  • TANIMOTO Akihide
    Department of Pathology, Kagoshima University Graduate School of Medical
  • FUROI Akira
    Department of Surgery, Kirishima Medical Center, Kirishima-shi

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Other Title
  • Dubin-Johnson症候群に発生した肝細胞癌の1例
  • Dubin-Johnson ショウコウグン ニ ハッセイ シタ カン サイボウ ガン ノ 1レイ

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Abstract

<p>A case of hepatocellular carcinoma in a patient with Dubin-Johnson syndrome (DJS) focusing on evaluation of hepatic functional reserve and the perioperative clinical course is presented.</p><p>A 66-year-old man with a medical history of DJS and diabetes mellitus was diagnosed with hepatocellular carcinoma (HCC) when he had a rickettsial infection. The preoperative liver function tests showed an increased bilirubin level (total 4.6, direct 3.4 mg/dl), and normal PT (92%) and albumin (4.2 g/dl) levels without ascites or encephalopathy. The Child-Pugh score was B (7). The ICGR15 level was 11%. The LHL15 value of the GSA scintigram was almost normal (0.909). S4 segmentectomy and S2 partial resection were performed uneventfully except for transient elevation of the T-Bil level that recovered to the preoperative level on the 28th postoperative day. DJS was confirmed on histopathological examination. Both the ICG test and the GSA scintigram evaluated hepatic functional reserve accurately. Inchin-ko-to may be effective for hyperbilirubinemia after hepatectomy in DJS cases.</p>

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