Assessment of single shot ethanol injection in treatment of HCC

The purpose of this work was to study the efficiency of percutaneous single shot ethanol injection [PEI] in the treatment of hepatocellular carcinoma [HCC] under general anesthesia. Twenty-three patients having 29 nodules of HCC were included in this study. They were followed up periodically for 18 months. Lesions were not more than 3 in number and the size of each nodule did not exceed 5 cm. The patients were divided into 2 groups according to Child classification A or B, respectively. Single shot US guided PEI of the tumors was done under general anesthesia [Deprivan]. The end point was complete opacification of the tumor. Measurement of serum alpha fetoprotein [AFP], prothrombin time and concentration [PT and PC] and alkaline phosphatase was done before and after PEI. Power duplex imaging [PDI], contrast enhanced CT and FNAB were also done before and after PEI to assess the vascularity and viability of the tumor, hence the therapeutic effect of single shot PEI. Fine needle aspiration biopsy [FNAB] was done few weeks after the procedure to confirm the tumor death. The study concluded that PEI is an effective and cheap non surgical method of treatment of small HCC that could be done in a single session under general anesthesia

Role of ultrasound duplex doppler studies in evaluation of portal hypertension in various stages of chronic liver disease

The present study was performed on 90 patients from various stages of chronic liver disease ranging from chronic hepatitis [19 patients], liver cirrhosis without varices [11], cirrhotics with varices that have not bled [30] and cirrhotics under regular sclerotherapy [30]. In addition, 30 normal subjects served as a control group. The obtained results revealed that the maximum and mean velocities of portal flow showed a significant slowing with advancement of hepatic conditions [P <0.001]. Similarly, velocities of splenic flow as well as the congestion index [CI] of both portal and splenic venins showed similar and statistically very highly significant differences with the deterioration of hepatic affection [P <0.0001]. Accordingly, duplex examination of the portal system together with calculation of the congestion index [CI] can be used to obtain a sensitive and noninvasive index for portal hypertension