A 72-year-old male underwent distal gastrectomy with D2 dissection for type 2 advanced gastric carcinoma. Nine months after the surgery, CT scan revealed a solitary liver metastatic legion with IVC invasion. We selected a surgical intervention because of allegic reaction of S-1 and rapid progression of tumor. Left hemihepatectomy and caudate lobectomy with IVC reconstruction was performed. IVC was resected partially and repaired with polytetrafluoroethylene (PTFE) patch graft. The postoperative course was uneventful. The patient was discharged on the 11th postoperative day. He is alive without a recurrence 9 months after surgery and is undergoing weekly paclitaxel. Although the indication of extended hepatectomy is controversial, aggressive surgery with chemotherapy would contribute to improve a prognosis of the patients with metastatic liver tumor from gastric carcinoma.
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