Surgical Treatment of Ruptured Hepatocellular Carcinoma / 한국간담췌외과학회지

ABSTRACT

BACKGROUND/AIMS: Spontaneous rupture causing massive hemoperitoneum is a potentially life-threatening complication of hepatocellular carcionma (HCC). Hepatic resection provides the only hope of cure for patients with a ruptured HCC. So we reviewed our clinical experience with surgical treatments for ruptured HCC. METHODS: Between October 1990 and April 2003, twelve cases were treated with liver resection for ruptured HCC at our department. The clinical records were reviewed retrospectively. RESULTS: Twelve patients underwent hepatectomy. Ages ranged from 44 to 69 years with a mean age of 54.4 years, and sex ratio was 51 with a male dominence. Liver cirrhosis was presented in 9 cases (75%). 9 cases of them underwent staged hepatectomy; the other 3 underwent emergency hepatectomy. Three patients were treated by transcatheter arterial embolization (TAE) before staged hepatectomy. The median survival time were 40 (4~2) months, and overall 1-year and 3-year cumulative survival rates were 81% and 36%. CONCLUSION: Surgical resection is the only procedure associated with long-term survival for resectable ruptured HCC with good liver function. With or without preoperative TAE, elective hepatectomy is a rational treatment for patients with ruptured HCC.