RESUMO
Objective To study the diagnosis and treatment of primary liver cancer(PLC) with bile duct cancer thrombus (BDT). Methods The clinical data of 21 patients with PLC and BDT admitted in the past 8 years were analyzed retrospectively . Results The major clinical manifestations were the symptoms of primary liver cancer and obstructive jaundice. The correct diagnosis rate was 76.2% before operation. The diagnosis rate of B-us, CT, MRI, ERCP and PTC was 14.3%, 9.52%, 14.3%, 71.4% and 100% respectively. The operative procedures included hepatectomy with removal of BDT ( n =10), hepatectomy combined with extrahepatic bile duct resection ( n =5), thrombectomy through choledochotomy with TACE ( n =3), removal of BDT with HAI ( n =3). The 3,5-year survival rate were 43.20% and 24.60% respectively. Conclusions Multi-examinations should be applied in the diagnosis of PLC with BDT. The comprehensive therapy including surgery and other therapies must be adoptted for PLC with BDT.
RESUMO
Objective To evaluate the effect of combination of surgery and transcatheter hepatic arterial chemotherapic embolism(THACE) with or without placement of drug deliery system(DDS) of portal vein for hepatocellular carcinoma with portal vein tumor thrombus (PVTT). Methods Fifteen cases of advanced HCC with PVTT were treated by hepatectomy, thrombectomy of portal vein with THACE,and 5 of the 15 cases received postoperative chemotherapy via portal vein. Results All patients survived after operation. The survival rate of 6,12,18 months was 15,12 and 9 cases respectively. Conclusions Operation is still an effective method for advanced HCC , postoperative comprehensive treatment can improve the survival rate.