Emergent hepatectomy and transcatheter arterial embolization for spontaneous rupture of primary hepatocellular carcinoma
10.3760/cma.j.issn.1008-6315.2009.11.025
- VernacularTitle:急诊肝切除术及肝动脉栓塞治疗原发性肝癌自发性破裂
- Author:
Jingyi WANG
;
Jinlong LIANG
;
Disi HAO
;
Zhengxi JIN
;
Guojin LIU
- Publication Type:Journal Article
- Keywords:
Hepatocellular carcinoma;
Hepatectomy;
Hepatic artery embolization;
Spontaneous rupture
- From:
Clinical Medicine of China
2009;25(11):1185-1187
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the indications,method and prognosis of emergent hepateetomy and tran-scatheter arterial embolization(TAE) for spontaneous rupture of primary liver carcinoma(PLC). Methods Clinical data of 85 cases with PLC were analyzed. Patients were divided into four groups: the group of delayed hepatectomy (group A,n=30);the group of emergent transcatheter arterial embolization (group B,n=22);the group of emer-gent hepatectomy (group C, n=18) and the group of medical treatment (group D, n=15). The hemostasis achieve-ment ratio, operative complications, perioperative morbidity, 1-year and 3-year survival rates among the four groups were compared. Results In group A and B, celiac urteriogram in 52 cases showed that extravasation of contrast media happened in 14 cases (26.9%). The hemostasis achievement ratio was 100% (30/30, 22/22, 18/18) in group A,B and C,respectively,which was remarkably higher than that in group D(40%,6/15) (P<0.05);The in-hospital fatality was 0% (0/30),3.8% (2/52) and 16.7% (3/18),which was lower than that of group D(80.0%, 12/15) (P<0.01). The 1-year survival rate was 76.7% and 3-year survival rate of group A was 53.3%, which was higher than that of group B (45.5 % and 31.8 %) and group C (44.4% and 33.3 %) (P<0.05). The cases in group D did not survive one year(P<0.01). Conclusions Emergent hepatectomy and transcatheter arterial emboli-zation are safe and feasible for spontaneous rupture of primary hepatocellular carcinoma. For those with resectable ca-ses,surgical resection is the first choice after transcatheter arterial embolization.
