Surgical intervention of hepatocellular carcinoma with bile duct thrombi / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVES</b>To summarize the experience of surgical intervention for hepatocellular carcinoma (HCC) with bile duct thrombi (BDT), and to evaluate the influence on prognosis.</p><p><b>METHODS</b>From 1994 to 2002, 15 patients with HCC and BDT who underwent surgical intervention were retrospectively analyzed.</p><p><b>RESULTS</b>The operative procedures included hepatectomy with removal of BDT (n = 7), hepatectomy combined with extrahepatic bile duct resection (n = 4), thrombectomy through choledochotomy (n = 3), and piggy-back orthotopic liver transplantation (n = 1). The 1- and 3-year survival rates were 73.3% and 40%, respectively. Two patients survived over 5 year. The survival rate of patients with portal vein invasion was significantly lower than that of patients without portal vein invasion (P < 0.05).</p><p><b>CONCLUSIONS</b>Surgical intervention was effective for patients with HCC and BDT. Operation after recurrence can prolong the survival time. Liver transplantation is a new operative procedure worthy of study.</p>