Additional Hassab's operation for esophagogastric varices in cirrhotic patients with resectable hepatocellular carcinoma.
OBJECTIVE
The aim of this study was to clarify the role of the additional Hassab's operation to hepatectomy in cirrhotic patients with resectable hepatocellular carcinomas and esophagogastric varices.


METHODS
Subjects were 36 cirrhotic patients with hepatocellular carcinomas and concomitant esophagogastric varices: 20 underwent hepatectomy alone (non-Hassab group) and 16 underwent hepatectomy with Hassab's operation (Hassab group).


RESULTS
Patients in the Hassab group had more advanced esophageal varices and the accompanied gastric varices, preoperatively (p<0.01). Both preoperative platelet counts (p<0.01) and prothrombin time (p<0.05) were significantly lower in the Hassab group, and serum albumin level also tended to be worse than those in the non-Hassab group. Portal pressure was significantly higher in the Hassab group (p<0.01). Despite these disadvantages, no significant differences were found in operative mortality, postoperative courses and long-term prognosis between the two groups. Comparing the cause of death, the incidence of the fatal variceal hemorrhage was significantly lower (0%) in the Hassab group than that (25%) in the non-Hassab group (p<0.05).


CONCLUSIONS
This study suggested that additional Hassab's operation to hepatectomy might have reduced the risk of variceal hemorrhage after hepatectomy.
Sugo
Hiroyuki
H
Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. sugo@med.juntendo.ac.jp
Fujiwara
Noriko
N
Yoshimoto
Jiro
J
Miwa
Ken
K
Ishizaki
Yoichi
Y
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013156:Splenectomy; D013270:Stomach / Q000098:blood supply; D016896:Treatment Outcome