title: Treatment of concomitant gastric varices in patients with hepatocellular carcinoma at a single Japanese institute.
abstract: Hepatocellular carcinoma (HCC) patients often have esophagogastric varices due to portal hypertension by chronic hepatitis or cirrhosis. Surgical treatment for gastric varices is necessary when the patient undergoes hepatic resection for HCC, simultaneously. We examined the clinical demographics, surgical records and outcome in 7 patients undergoing both hepatectomy and Hassab's operation (=decongestion of upper gastric veins and splenectomy) between 1994 and 2007. All patients had HCC, including chronic injured liver diseases. Preoperative liver functions were well preserved in all patients. Right hepatectomy was performed in two patients and limited resections in 5. Three patients had postoperative complications and the in-hospital death by hepatic failure was observed in one. Four patients had tumor recurrence within one year and 3 were dead, while, two patients had long-term survival with or without recurrence of HCC. Following Hassab's operation, gastric varices dramatically disappeared. Portal hypertension and hypersplenism were significantly improved. Simultaneous operation with Hassab's procedure and hepatectomy is useful and can be safely performed in HCC patients with gastric varices.
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. a-nanasm@nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Kenichirou
authors.initials: K
authors.lastname: Shibata
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tomoshige
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Fukuoka
authors.forename: Kouji
authors.initials: K
authors.lastname: Mochinaga
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome