Research progress of intraoperative cholangiography in laparoscopic cholecystectomy / 国际外科学杂志

With the widespread implementation of laparoscopic cholecystectomy in various levels of medical institutions, surgical complications have also increased. Among them, the incidence of bile duct injury remains high in complex laparoscopic cholecystectomy. The reason for this is that surgeons cannot effectively and accurately identify the relationship between the aberrant bile duct and the cystic duct and the common bile duct, resulting in the accidental injury of the bile duct, resulting in long hospital stays, increased medical costs, and decreased long-term quality of life for patients. Intraoperative cholangiography, as a real-time visual method of biliary presentation, can effectively reduce the incidence of iatrogenic bile duct injury. However, most surgeons do not fully understand the technology of intraoperative cholangiography during cholecystectomy. This article reviews the application of intraoperative cholangiography in laparoscopic cholecystectomy based on the clinical experience of the author′s team and the literature in recent years, with the aim of deepening the understanding of surgeons about intraoperative cholangiography, so as to better apply it to clinical practice and benefit patients.

Recurrence and prognosis of hepatocellular carcinoma after liver transplantation in different age qronps / 中华器官移植杂志

Objective:To evaluate the long-term prognosis and recurrence of young liver transplant recipients with hepatocellular carcinoma(HCC).Methods:Based upon the database of liver transplantation center, clinical data were retrospectively reviewed for 39 young recipients(18~40 years)and 158 middle-aged and elderly recipients(over 40 years)from 2013 to 2017. The parameters of overall survival(OS), recurrence-free survival(RFS)and disease-specific survival(DSS)were compared between two groups.Cox's proportional hazard model was utilized for evaluating the prognostic factors.Results:Significant inter-group difference existed in recurrence rate of HCC. Kaplan-Meier analysis revealed no significant difference in OS rate(1/3-year OS, 82.1%, 66.7% and 86.1%, 74.7%, P>0.05)and DSS rate(1/3-year DSS, 94.9%, 82.1% and 99.4%, 91.1%, P=0.053); RFS rate(1/3-year RFS, 51.3%, 41.0% and 73.0%, 62.7%, P=0.008)showed significant differences; Cox multivariate analysis revealed that AFP>400 μg/L was an independent risk factor for OS, DSS and RFS; poorly differentiated tumors and positive micro-vascular invasion(MVI)were independent risk factor for DSS; poorly differentiated tumors and total tumor size >5 cm were independent risk factors for RFS. Conclusions:Although RFS of young adult group is worse than that in middle-aged and elderly group after LT, no significant inter-group difference exists in OS or DSS. And LT is still a quite effective treatment for young HCC patients.

The implementation of multi-disciplinary treatment and whole course management in hepatocellular carcinoma / 中华肝胆外科杂志

In China, hepatocellular carcinoma (HCC) accounts for about 50% of cases in the world, which is still challenging. The implementation of multi-disciplinary treatment (MDT) and whole course management of HCC are conducive to improve the prognosis of patients, so as to achieve the goal of increasing by 15% of overall survival of HCC patients as proposed by the "Healthy China 2030" . The standardized management of HCC includes several key points, such as exact diagnosis of the HCC, selection of proper treatment methods, individual postoperative adjuvant therapy and regular follow-up. MDT is the key measure to implement the standardized and whole course management of HCC. Herein, the author tends to summary the experience on standardized management of HCC.

Tenofovir vs. entecavir on recurrence of hepatitis B virus-related hepatocellular carcinoma beyond Milan criteria after hepatectomy / 中华医学杂志(英文版)

BACKGROUND@#Hepatectomy for hepatocellular carcinoma (HCC) beyond the Milan criteria is shown to be beneficial. However, a high rate of post-operative HCC recurrence hinders the long-term survival of the patients. This study aimed to investigate and compare the impacts of tenofovir (TDF) and entecavir (ETV) on the recurrence of hepatitis B viral (HBV)-related HCC beyond the Milan criteria.@*METHODS@#Data pertaining to 1532 patients who underwent hepatectomy and received antiviral therapy between January 2014 and January 2019 were collected from five centers. Recurrence-free survival (RFS) analysis was performed using the Kaplan-Meier method. Cox proportional hazards regression analysis was performed to determine prognostic factors for HCC recurrence.@*RESULTS@#The analysis incorporates 595 HBV-related HCC patients. The overall 5-year RFS was 21.3%. Among them, 533 and 62 patients received ETV and TDF treatment, respectively. The 1-, 3-, and 5-year RFS rates were 46.3%, 27.4%, and 19.6%, respectively, in the ETV group compared with 65.1%, 41.8%, and 37.2%, respectively, in the TDF group (P < 0.001). Multivariate analysis showed that TDF treatment (hazard ratio [HR]: 0.604, P = 0.005), cirrhosis (HR: 1.557, P = 0.004), tumor size (HR: 1.037, P = 0.008), microvascular invasion (MVI) (HR: 1.403, P = 0.002), portal vein tumor thrombus (PVTT) (HR: 1.358, P = 0.012), capsular invasion (HR: 1.228, P = 0.040), and creatinine levels (CREA) (HR: 0.993, P = 0.031) were statistically significant prognostic factors associated with RFS.@*CONCLUSIONS@#Patients with HCC beyond the Milan criteria exhibited a high rate of HCC recurrence after hepatectomy. Compared to the ETV therapy, TDF administration significantly lowered the risk of HCC recurrence.

Novel Prognostic Nomograms for Hepatocellular Carcinoma Patients with Microvascular Invasion: Experience from a Single Center

BACKGROUND/AIMS: Microvascular invasion (MVI) is an established risk factor for hepatocellular carcinoma (HCC). However, prediction models that specifically focus on the individual prognoses of HCC patients with MVI is lacking. METHODS: A total of 385 HCC patients with MVI were randomly assigned to training and validation cohorts in a 2:1 ratio. The outcomes were disease-free survival (DFS) and overall survival (OS). Prognostic nomograms were established based on the results of multivariate analyses. The concordance index (C-index), calibration plots and Kaplan-Meier curves were employed to evaluate the accuracy, calibration and discriminatory ability of the models. RESULTS: The independent risk factors for both DFS and OS included age, tumor size, tumor number, the presence of gross vascular invasion, and the presence of Glisson's capsule invasion. The platelet-to-lymphocyte ratio was another risk factor for OS. On the basis of these predictors, two nomograms for DFS and OS were constructed. The C-index values of the nomograms for DFS and OS were 0.712 (95% confidence interval [CI], 0.679 to 0.745; p<0.001) and 0.698 (95% CI, 0.657 to 0.739; p<0.001), respectively, in the training cohort and 0.704 (95% CI, 0.650 to 0.708; p<0.001) and 0.673 (95% CI, 0.607 to 0.739; p<0.001), respectively, in the validation cohort. The calibration curves showed optimal agreement between the predicted and observed survival rates. The Kaplan-Meier curves suggested that these two nomograms had satisfactory discriminatory abilities. CONCLUSIONS: These novel predictive models have satisfactory accuracy and discriminatory abilities in predicting the prognosis of HCC patients with MVI after hepatectomy.

Nomograms to Predict the Individual Survival of Patients with Solitary Hepatocellular Carcinoma after Hepatectomy

BACKGROUND/AIMS: Solitary hepatocellular carcinoma (HCC) is a subgroup of HCCs. We aimed to establish nomograms for predicting the survival of solitary HCC patients after hepatectomy. METHODS: A total of 538 solitary HCC patients were randomly classified into training and validation sets. A Cox model was used to identify predictors of overall survival (OS) in the training set. A nomogram was generated based on these predictors and was validated using the validation set. RESULTS: Tumor size, microvascular invasion, and major vascular invasion were significantly associated with OS in the training set. Nomograms were developed based on these predictors in the multivariate analysis. The C-index was 0.75 for the OS nomogram and 0.72 for the recurrence-free survival nomogram. Compared to the index of conventional staging systems for predicting survival (0.71 for Barcelona Clinic Liver Cancer, 0.66 for the seventh American Joint Committee on Cancer, 0.68 for Cancer of the Liver Italian Program, and 0.70 for Hong Kong Liver Cancer), the index of the OS nomogram was significantly higher. Moreover, the calibration curve fitted well between the predicted and observed survival rate. Similarly, in the validation set, the nomogram discrimination was superior to those of the four staging systems (p<0.001). CONCLUSIONS: The nomograms demonstrated good discrimination performance in predicting 3- and 5-year survival rates for solitary HCCs after hepatectomy.

Prognosis of surgical excision combined with interventional therapy in treatment of hepatocellular carcinoma with microvascular invasion / 局解手术学杂志

Objective The aim of this study is to analyze the long-time outcome of hepatocellular carcinoma(HCC)patients with micro-vascular invasion underwent liver resection combined with transarterial chemoembolization(TACE).Methods Our database of surgical re-section from January 2009 to September 2015 was retrospectively analyzed.This study was conducted on 296 HCC patients with MVI.Patients were divided into two groups:one group underwent liver resection (n =159)and another for liver resection combined with TACE (n =137). The 5-year overall survival rate (OS)and disease free survival (DFR)were compared.A multivariate Cox proportional hazards regression a-nalysis was performed to assess the prognostic risk factors associated with overall survival rate.Results The 5-year OS and 5-year DFR see significant difference (OS:18% vs.8%,P =0.001;TRF:15% vs.8%,P =0.008).Multivariate analysis revealed that HBsAg(HR 1.596, P =0.002,95% CI 1.194 ~2.131),tumor size >5 cm(HR 0.729,P =0.042,95% CI 0.539 ~0.989)as well as multiple tumors(HR 1.480,P =0.049,95% CI 1.002 ~2.186)were correlated to poor overall survival rate.Conclusion Surgical resection combined TACE for HCC patients with MVI realized a better prognosis than patients merely underwent therapy of resection.

Research on tumor suppressor mechanisms of maternally expressed gene 3 / 国际外科学杂志

As long non-coding RNA (LncRNA) research boom,Maternally Expressed Gene 3(MEG3) as LncRNA family is also a widespread concern.MEG3 not been studied in benign disease,and malignant disease more and more in-depth research.MEG3 because of the uniqueness of the tumor suppressor much attention in cancer research,but its specific mechanism of action of tumor suppressor and associated pathways have not been yet entirely clear,remains to be further research and clarify.This article will be now anticancer activity MEG3 and related Pathway summarized.

Updates of radical antegrade modular pancreatosplenectomy applied to the surgical treatment for pancreatic carcinoma of body and tail / 中华消化外科杂志

The traditional distal pancreatosplenectomy (DPS) has been the standard surgical procedure for the treatment of resectable pancreatic carcinoma of body and tail.With the development of medical technology,however,the results including the rate of R0 resection,number of lymph nodes dissected and postoperative 5-year survival rate were not significantly improved after DPS.According to pancreatic anatomy and phylembryogenesis,combined with renewed tumor treatment concept,the radical antegrade modular pancreatosplenectomy (RAMPS) was put forward after continuous exploration of pancreatic surgeons to improve prognosis of patients with pancreatic carcinoma of body and tail.Compared with DPS,RAMPS has advantages of R0 resection rate and regional lymphadenectomy and might become the standard surgical procedure.

Analysis of risk factors of initial poor graft function after living donor liver transplantation / 器官移植

Objective To identify the risk factors of the incidence rate of initial poor graft function (IPGF)in recipients after living donor liver transplantation. Methods Clinical data of 309 patients undergoing living donor liver transplantation were retrospectively analyzed. Candidate risk factors:(1 )donor factors included age,gender and body mass index (BMI);(2)recipient factors included age,gender,BMI and preoperative Child-Pugh classification,model for end-stage liver disease (MELD)grading,preoperative renal insufficiency,serum total bilirubin elevation,hyponatremia and hypopotassaemia;(3)graft factors included graft cold ischemia time,graft recipient weight ratio (GRWR);(4)recipient surgery factors included total operation time,blood loss volume,blood transfusion volume,platelet transfusion and anhepatic phase≥1 00 min. Single factor analysis was performed to identify the potential risk factors of IPGF. Logistic regression analysis was conducted to explore independent risk factors. Results and Conclusions Child-Pugh C of preoperative recipient liver function,MELD score≥20,serum total bilirubin elevation(>68. 4μmol/L),hyponatremia(<1 35 mmol/L), hypopotassaemia (<3. 5 mmol/L)and anhepatic phase≥1 00 min were potential risk factors of IPGF (all P<0. 05 ). Child-Pugh C of preoperative recipient liver function was an independent risk factor of the incidence rate of IPGF following living donor liver transplantation (P=0. 01 9).

Clinical experience analysis of liver transplantation from donation after citizen’s death in 78 cases / 器官移植

Objective To summarize the clinical experience and effect analysis of liver transplantation from donation after citizen’s death. Methods Clinical data of 76 donors and 78 recipients of liver transplantation from donation after citizen’s death completed in Liver Transplantation Center of West China Hospital,Sichuan University from March 2012 to November 2015 were analyzed retrospectively.The functional recovery of early allografts in liver transplant recipients was observed and the risk factors causing early allograft dysfunction (EAD)were analyzed.In addition,long﹣term survival of allografts and recipient as well as complications was observed. Results The incidence of postoperative EAD was 36%(28 /78)in 78 recipients.High total bilirubin (TB)and long cold ischemia time constituted the risk factors of EAD. Survival rate of the recipients was 92% (72 /78)during perioperation,and 6 cases died,of which 4 cases died of primary graft dysfunction,1 case of upper gastrointestinal hemorrhage and 1 case of pulmonary infection.Postoperative abdominal infection occurred in 5 cases,with biliary stricture in 3 cases and vascular thrombosis in 2 cases.One case died,and the rest were improved after corresponding treatment.The 1﹣year survival rate of the recipients was 84.2% and 2﹣year survival rate was 80% after operation. Conclusions Liver transplantation from donation after citizen’s death realizes favorable short and long﹣term effects,which can be regarded as a good source of donor livers.Important measures such as controlling the preoperative quality of donor liver and shortening the cold ischemia time can improve the clinical effect.

The early postoperative complications in living liver transplantation donors / 中华器官移植杂志

ObjectiveTo investigate the incidence of early postoperative complications in living donor liver transplantation.MethodsPostoperative data of 170 living liver donors were retrospectively collected from January 2002 to August 2009 and the collected data were divided into two groups according to the type of donors (right-lobe graft,R group and left lobe graft,L group). Early postoperative complications were analyzed using Clavien classification system.ResultsThe difference between two groups was no statistically significant in donor's age,body mass index,operation time and other characters (P＞0.05).R group had a bigger actual cut weight of donor liver (P＜0.05),smaller residual liver weight (P＜0.05) which also smaller than standard liver weight (P＜0.05),and a longer hospital stay (P＜0.05) than L group.During hospitalization,62 complications occurred in 55 cases with the total complication rate being 32.35％ (55/170). In detail,the incidence of complications was 34.39％ (54/157) in R group,and 7.69％ (1/13) in L group (chi-square value =2.787,P＞0.05).Among these 62 complications,there were 39 times of Ⅰ grade,5 times of Ⅱ grade,16 times of Ⅲ grade,2 times of Ⅳ a grade. All the complications were cured by active treatment and all donors survived well.Conclusion Although the security of living donor liver transplantation is better,the risk of serious complications must be faced.We must strictly select and assess the donor before the operation,very carefully carry out surgical operation,and pay more attention to postoperative management in order to avoid postoperative complications of donors.

The early liver function recovery in living liver transplantation donors / 中华普通外科杂志

Objective To investigate the liver function injury and the rate of complications in living liver transplantation donors in different graft type transplantation.Methods Postoperative data of 154 living liver donors satisfying our inclusion criteria were prospectively collected and registered from Jan 2002 to May 2009 in our hospital.We divided the donors into two groups (right-lobe graft, R group and left-lobe graft, L group), and made comparison on the liver function and complications.Results Remnant liver weight in R group were smaller than those in L group (t = 11.418, P ＜ 0.05).the ratio of remnant liver weight to standard liver weight in R group were smaller than those in L group (t = - 5.040, P ＜ 0.05 ) .Peaks of ALT, AST and INR in both groups appeared on the first day after operation, while the peak of TB in R group appeared on the third day after operation.All the index values returned to a normal baseline after reaching its peak.Mean values of TB in R group were higher than those in L group on the 1st, 3rd, 7th day after operation (seperately t1 = 5.285, t3 = 3.747, t7 = 2.729, all P ＜ 0.05).Mean values of INR in R group were higher than those in L group on the 1st, 3rd, 7th day after operation (seperately t1 = 5.260, t3 = 5.035, t7 = 2.267, all P ＜ 0.05).The level of TB in both groups returned to normal range on the 7th postoperative day, while the level of ALT and AST remained twice the upper limits of the normal.There were no deaths; Complications occurred in 53 of 154 donors (34.42% ) , 52/141 (36.88% ) in R group and 1/13 (7.69% ) in L group (x2 = 3.292, P ＞ 0.05).Conclusions Ramnant liver function of R group during early postoperative period was poorer than that of the L group.Donors were safe, though suffering from comparatively high complication rate.

Evaluation of standard liver volume formulas by right liver living donor liver transplantation / 中华普通外科杂志

Objective To evaluate the suitability of reported standard liver volume formulae for Chinese adults based on the practice of 216 cases of living donor liver transplantation in our transplantation center. Methods The graft volume was preoperatively estimated in 179 adult-to-adult right liver living donors by two methods: first, the radiological right liver volume by computed tomography (CT) and second,calculated graft volume obtained by reported standard liver volume formula and the percentage of the right liver volume ( given by CT). Both results were compared to the actual graft volume measured during surgery.Results The mean percentage of right liver volume was 55.4% (SD 5.41%). The results of Urata、Heinemann、Vauthey、 Lee、 Yoshizumi formula were significantly larger than the actual right liver volume (P ＜0. 01 ). The result of Sheung-tat Fan was less than the actual right liver volume, there was statistical ESLV =334. 024 + 11. 508 × BW, is most suitable to estimate adult Chinese donor's right liver volume.

A comparative study on continuous hemihepatic with intermittent total hepatic inflow occlusion in hepatectomy for liver tumors / 中华普通外科杂志

Objective To evaluate if continuous hemihepatic inflow occlusion(HH)during hepatectomy can be as safe and effective as intermittent total hepatic inflow occlusion(TH)in reducing blood loss during hepatectomy.Methods From November 2001 to March 2006.eighty patients undergoing liver resections were included in a prospective randomized study comparning the intra-and postoperative course underTH(n=40)or HH(n=40).TH was performed with periods of 20 minutes of occlusion and 5 minutes of releasing,while HH with continuous occlusion.The surface area of liver transection was measured and blood loss was calculated.The amount of blood loss,levels of alanine aminotransferuse (ALT)and aspartate aminotransferase(AST),and postoperative course were recorded. Results The total ischemic time of the HH groups was longer than in the TH group[(42±13)min,(31±13)min,P=0.37],and the operative time in the HH group was longer than in the TH group[(236 ±49)min,(204±38)min,P=0.02 ].No signincant difierenee was found between HH and TH group in blood loss during liver parenchyma transection[(500 ±269)ml,(416 ±235)ml,P=0.14]and in the changes of ALT and AST on the first postoperative day[ALT:(677±572)IU/L,(577 ±327)IU/L,P=0.12;AST:(591 ±468)IU/L,(512±301)IU/L,P=0.66].There were no difierences on postoperative morbidity between the two groups(22.5%versus 20.0%,P=0.35).Conclusion The technique of continuous hemihepatic inflow occlusion is as safe and effective as intermittent total hepatic inflow occlusion.

Liver functions after periesophagogastric devascularization / 中华普通外科杂志

Objective To observe changes of hepatic hemodynamics and hepatic functional reserve after splenectomy and periesophagogastric devascularization. Methods From July 2006 to August 2007, thirty patients with portal hypertension caused by hepatitis B cirrhosis underwent splenectomy and periesophagogastric devascuiarization. The PVPG (portal venous pressure gradient) was measured by inductor continually during operation. The HAF (hepatic artery flow), PVF (portal venours flow) and hepatic arterial RI(resistant index) were measured with Doppler sonography. The EHBF(effective hepatic blood flow) and ICGR15 (indocyaninegreen retention rate at 15 minutes) were obtained respectively by indocyaninegreen clearance test before and after the operation. Results PVPG after laparotomy (19±4) mm Hg, ligating the splenic artery(14±4) mm Hg, splenectomy(14±3)mm Hg and periesophagogastric devascularization (12±4) mm Hg showed a tendency to decrease progressively. The PVF decreased [from (42±14) ml/s to (16±8) ml/s] and HAF increased in compensation after operation. The EHBF increased [from (0.48±0.10) L/min to (0.56±0.10) L/min], and the ICGR15 decreased (from 23%±8% to 18%±4%) postoperatively. Conclusion After splenectomy and periesophagogastric devascularization, the hepatic functional reserve improves at least in a short term notwithstanding the decrease of PVPG and PVF.

Preliminary Experience with Indications for Liver Transplantation for Hepatolithiasis / 中国普外基础与临床杂志

Objective To explore the indications for liver transplantation among patients with hepatolithiasis.Methods Data from 1 431 consecutive patients with hepatolithiasis who underwent surgical treatment from January 2000 to December 2006 were retrospectively collected for analysis.Surgical procedures included T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones,hepatectomy,cholangiojejunostomy,and liver transplantation.Results Nine hundred and sixty-one patients who had a stone located in the left or right intrahepatic duct underwent hepatectomy or T-tube insertion combined with intraoperative cholangioscopic removal of intrahepatic stones.The rate of residual stones was 7.5%(72/961).Four hundred and seventy patients who had a stone located in the bilateral intrahepatic ducts underwent surgical procedures other than liver transplantation;the rate of residual stones was 21.7%(102/470).Only 15 patients with hepatolithiasis underwent liver transplantation;they all survived.According to the degree of biliary cirrhosis,recipients were divided into 2 groups: a group with biliary decompensated cirrhosis(n=7),or group with biliary compensated cirrhosis or noncirrhosis group(n=8).There were significant differences in operative times,transfusion volumes and blood losses between 2 groups(P

Reconstruction of hepatic artery in adult-to-adult living donor liver transplantation: a report of 50 cases / 中华消化外科杂志

Objective To summarize the experience in hepatic artery reconstruction in adult-to-adult living donor liver transplantation(ALDLT).Methods Fifty patients underwent ALDLT in our hospital from January 2002 to July 2006.All the hepatic a~ery reconstructions were done under surgical microscope.ResultsTwo patients(4%)presented with hepatic artery thrombosis.All the patients were followed up for 2 to 52 months (median,9 months),and no hepatic artery stenosis nor hepatic artery pseudoaneurysm occurred.The 1-year survival rate was 92%(46/50).Conclusions Systematic evaluation of hepatic artery reconstruction and use of microsurgical technique are key to the reduction of complications of hepatic artery reconstruction in ALDLT.

Biliary reconstruction and treatment of biliary complications in orthotopic live r transplantation / 中华器官移植杂志

Objective To investigate the technique of b iliary reconstruction and treatment of biliary complications in orthotopic liver transplantation (OLT). Methods From Feb. 1999 to Jan. 2003, OLT was performed in 103 patients with end-stage l iver disease. OLT was performed with standard techniques with or without a veno -venous bypass. Reconstructions of biliary tract were performed using choledoc hocholedochostomy (CDC) or Roux-en-Y choledochoje- junostomy (RCDJ). CDC was carried out in 94 cases, with T tube (CDCT) in 62 cases and without T tube (CDCO ) in 32 cases respectively. Among the 32 cases without T tube, 11 had a small tu be placed in the common bile duct through the recipient cystic duct. RCDJ was pe rformed in 9 cases without internal stent. Diagnosis of the biliary complication s after OLT was based on the clinical manifestations, ultrasound findings, MRCP and ERCP. All the patients were followed up regularly after discharge for 12 to 48 months. Results The overall incidence of biliary complications in 103 patients after OLT was 7 .8% (8/103). Of the 62 cases of CDCT posttransplant, biliary complications occ urred in 6 cases ( 9.6% ), including 4 cases of bile leaks following OLT and 2 cases of bile leaks following T-tube removed. Of the 32 patients subject to CD CO, 1 ( 3.1% ) had stricture of anastomosis. Of the 9 cases subject to RCDJ, one patient was complicated with bile leaks at the anasto mosis. Two cases of the bile leaks were drained reoperatively, and others were k ept adequate drained. The patient with stricture of CDCO was cured by balloon di latation and stent placed endoscopically. No death associated with biliary compl ications occurred. Conclusions Bile leaks and stricture of anatomosis are the common biliary complications afte r OLT. Good blood supply to biliary tract and surgical technique are the keys to prevent biliary complications after OLT. The timely endoscopical and radiologic al technique is a valuable nonoperative precedure for diagnosis and treatment of biliary complicat ions.

Liver Transplantation for Recurrent Liver Cancer after Resection / 中国普外基础与临床杂志

Objective To evaluate the outcome of liver transplantation in patients with recurrent liver cancer after resection.Methods Data of 23 patients underwent liver transplantation for recurrent liver cancer from April 2001 to March 2008 were retrospectively collected and analyzed.Results Previous history of liver resection had little negative effect in subsequent liver transplantation in technical aspect.Liver function recovered uneventfully after transplantation in all cases.Alpha fetoprotein(AFP) recovered to normal value in 13 of 17 cases with elevated AFP before transplantation within one month after operation.Five cases(21.74%) had postoperative complications.Nineteen cases(82.61%) were followed up,average follow-up duration were 610 days.There were 5 cases(26.32%) of cancer recurrence and 6 deaths during follow-up,survival rate was 68.42%.Conclusion Liver transplantation is a reasonable treatment for recurrent liver cancer after resection.