title: Hepatocellular carcinoma with bile duct thrombi: analysis of surgical treatment.
abstract: 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.
authors.affiliation: Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors.forename: Shu-You
authors.initials: SY
authors.lastname: Peng
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Wang
authors.forename: Ying-Bin
authors.initials: YB
authors.lastname: Liu
authors.forename: Xiu-Jun
authors.initials: XJ
authors.lastname: Cai
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Gui-Long
authors.initials: GL
authors.lastname: Deng
authors.forename: Hai-Jun
authors.initials: HJ
authors.lastname: Li
mesh_terms: 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*