Treatment of spontenous rupture of hepatocellular carcinoma(a report of 64 cases) / 中国普通外科杂志

ABSTRACT

Objective To study the treatment of sponteneous rupture of hepatocellular carcinoma(SRHCC).Methods The clinical data of 64 patients with SRHCC treated by non-operation or operation were analysed retrospectively.Results The mean survival time of 14 patients treated by conservative therapy was 7 days(12 hours～12 days), the mean surival time of 31 patients treated by packing and 6 patients treated by ligation of hepatic artery was 11 days(4 hours-3 months)and 2.5 months(8 days-6 months);and the 1-month survival rate was 3.2% and 66.7% respectively.1 patient underwent transhepatic artery embolism surviving 9 days.The 1-year survival rate of 12 patients treated by hepatectomy was 66.7%;the mean survival time was 36 months(4 days-25 years and 3 months).Of the 12 patients,11 survived for over one and a half months whose liver function was Child-Pugh grade A before operation; 1 died of liver function failure 4 days after operation,whose liver function was Child-Pugh grade B before operation.Conclusions Emergent hepatectomy should be reserved for patients with an easily resectable lesion whose liver function is in Child-Pugh grade A.Early two-stage or delayed hepatectomy would be suitable for those patients who are unsuitable for emergent operation.Conservative therapy and other therapies may be used for patients with terminal stage of SRHCC.