Surgery of icteric-type hepatoma after biliary drainage and transcatheter arterial embolization.
OBJECTIVE
The authors aimed to study the importance of pre-operative jaundice reduction in the surgical treatment of icteric-type hepatoma (IHCC).


METHODS
A series of 10 patients with IHCC was reviewed. Eight out of the 10 patients underwent biliary drainage. Obstructive jaundice in the other 2 patients resolved spontaneously. Nine patients subsequently underwent transcatheter arterial embolization (TAE), which appeared to have an additional effect in reducing jaundice.


RESULTS
Consequently, 9 of the 10 patients achieved sufficient reduction of the jaundice preoperatively. After the evaluation of liver function, 8 patients underwent hepatectomy without any appreciable morbidity or mortality. The median survival time of the resected cases was 18 months.


CONCLUSIONS
A combination of biliary drainage and subsequent TAE is a recommended pre-operative strategy for the successful surgical treatment of IHCC.
Tada
K
K
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Kubota
K
K
Sano
K
K
Noie
T
T
Kosuge
T
T
Takayama
T
T
Makuuchi
M
M
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002780:Cholestasis, Intrahepatic / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D015996:Survival Rate