[Transarterial embolization for hemorrhage due to spontaneous rupture in hepatocellular carcinoma].
OBJECTIVE
To evaluate the efficacy of transarterial embolization (TAE) for intraperitoneal hemorrhage due to spontaneous rupture in hepatocellular carcinoma (HCC).


METHODS
Fourty-two patients with ruptured HCC were divided into 4 groups according to the type of their previous treatment: Group A-TAE followed by elective hepatectomy 15, Group B- TAE alone 11, Group C-emergency operation 6 and group D-medical conservative management 10.


RESULTS
Celiac arteriography done before the present treatment showed extravasation of contrast material in 7 (26.9%) of the 26 patients in group A and B, and hypervascular tumor was observed in the rest. The hemostasis success rate of group A, B and C were 100%, which were much higher than that of group D (40%) (P < 0.05). The in-hospital mortality rates of group A, B and C were 0, 3.8% and 16.7% (P > 0.05), which were much lower than that of group D (80%) (P < 0.01). The 1-year survival rate of group A (76.3%) was higher than those in groups B (47.5%) and C (43.7%) (P < 0.05). There was no 1-year survivor in group D.


CONCLUSIONS
Transarterial embolization is safe and effective for hemorrhage due to spontaneous rupture in hepatocellular carcinoma. For resectable lesions, TAE is a preferential treatment to be given first, then followed by elective hepatectomy.
Yang
Yefa
Y
Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
Cheng
Hongyan
H
Xu
Aimin
A
Chen
Dong
D
Wang
Yi
Y
Yao
Xiaoping
X
Chen
Han
H
Wu
Mengchao
M
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000150:complications*