Hepatocellular carcinoma with bile duct thrombi: analysis of surgical treatment.
OBJECTIVE
To summarize the experience of surgical intervention for hepatocellular carcinoma with bile duct thrombi, and to evaluate the influence on prognosis.


METHODS
From 1994 to 2002, 15 patients with hepatocellular carcinoma and bile duct thrombi who underwent surgical intervention were retrospectively analyzed. The operative procedures included hepatectomy with removal of bile duct thrombi (n=7), hepatectomy combined with extrahepatic bile duct resection (n=4), thrombectomy through choledochotomy (n=3), and piggyback orthotopic liver transplantation (n=1).


RESULTS
The 1- and 3-year survival rates were 73.3% and 40%, respectively. Two patients survived over 5 years. There were no significant differences in the survival rates between patients with and without obstructive jaundice (P>0.05). The survival rate of patients with portal vein invasion was significantly lower than for those without portal vein invasion (P<0.05).


CONCLUSIONS
Surgical intervention was effective for patients with hepatocellular carcinoma and bile duct thrombi. Operation for recurrent intrahepatic tumor can prolong the survival period. Liver transplantation is a new operative procedure worthy of investigation.
Peng
Shu-You
SY
Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Wang
Jian-Wei
JW
Liu
Ying-Bin
YB
Cai
Xiu-Jun
XJ
Xu
Bin
B
Deng
Gui-Long
GL
Li
Hai-Jun
HJ
D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000150:complications / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013927:Thrombosis / Q000150:complications / Q000601:surgery*