[Usefulness of measurement of hepatic arterial blood flow during surgery to insert an arterial reservoir in unresectable hepatocellular carcinoma].

In a case of hepatocellular carcinoma, complicated with celiac arterial constriction, for which resection was impossible, we measured the blood flow in the hepatic artery using an ultrasonic, transit-time rheometer during surgery, and consequently inserted a reservoir safely. The measurement of the blood flow in this case demonstrated that the proper hepatic artery was provided with blood from superior mesenteric artery by the gastroduodenal artery and that the blood flow of the common hepatic artery was directed to the root part of the celiac artery. Moreover, because blood flow through the proper hepatic artery was greater while clamping the common hepatic artery than the gastroduodenal artery, cannulation was carried out from the common hepatic artery. Postoperatively, when recombinant interleukin-2(rIL-2) was infused from the reservoir, the tumor disappeared on imaging pictures, and the level of AFP (which was high preoperatively) was reduced, which was thus judged as a complete response. These results indicated the usefulness of measurement of blood flow in surgery of inserting a reservoir in cases with abnormal blood circulatory dynamics.