Objective To investigate the efficiency of liver cancer with portal vein tumor thrombus (MPVTT),hepatic artery portal vein fistula (APVS) in patients with hepatic artery chemoembolization (TACE) combined with the clinical value of portal vein stent during treatment with APVS embolization.Methods From January 2012 to October 2014,59 cases of HCC patients who accepted the treatment of TACE + stent in portal vein embolization of + APVS surgery,companied with MPVTT and APVS were ret rospectively analyzed.The liver function,portal vein angiography and pressure at different time points were measured and compared before and after treatment,and follow-up and prognosis were recorded.Results After treatment with albumin,platelets (PLT) levels were higher than those before treatment (P ＜ 0.05),with PT values lower than before treatment (P ＜ 0.05).No statistical significance was found for aspartate aminotransferase (AST),alanine aminotransferase (ALT) before and after treatment (P ＞ 0.05).Stent implantation before and after stent implantation,the portal venous pressure of APVS embolization had signif icant difference (P ＜ 0.05).Portal venous pressure level of stent implantation was lower than before stent implantation (P ＜ 0.05).The portal venous pressure level of APVS embolization was lower than the stent implantation before and after stent implantation (P ＜ 0.05).At the 12 months after treatment,28 cases survived (47.46％);24 months after treatment,11 cases survived (18.64％) of the group;a total of 3 patients was lost to follow-up,the median survival time of the patients 24 months 16.5 months.Conclusions Liver cancer with MPVTT and APVS in the TACE combined with portal vein stent in the treatment process using APVS embolization can further improve the portal vein blood flow,and reduce the pressure of Dortal vein.

Objective To investigate the clinical application value of liver transarterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE) in the treatment of two stage hepatectomy.Methods From January 2010 to December 2013,120 patients with liver tumors who were not suitable for one stage hepatectomy admitted to our department were enrolled in this study.Among them,60 (control group) received TACE therapy and 60 (observation group) accepted TACE combined with SPVE treatment.The liver function,liver volume change,the second stage resection,survival rate,complication and adverse reaction were compared between the two groups after treatment,and the application value of the therapy was analyzed.Results All the patients were successfully completed the treatment.The aspartate aminotransferase (AST),alanine aminotransferase (ALT),and total bilirubin (TB) of the two groups were all recovered to the pre-treatment level on the 7th day after treatment,and there was no statistical difference between the two groups (P ＞ 0.05).Except for the 6th months,the survival rates of the observation group in 12th months,18 months and 24 months were all higher than those in the control group.The liver volume of the control group and the observation group increased to varying degrees,and the tumor volume showed varying degrees of atrophy.The residual liver volume (RLV) of the observation group was (527.29 ±58.69) cm3,which was increased and higher than the control group before the treatment (P ＜ 0.05).The implementation rate of the second stage operation was also higher than that of the control group (P ＜ 0.05).There were no serious complications in the two groups,and there was no significant difference between the two groups about adverse reactions (P ＞ 0.05).Conclusions The treatment of TACE combined with SPVE can effectively control tumor growth,increase RLV,so as to improve the resection rate and survival rate of patients with primary hepatectomy who can not undergo primary resection.