scholarly journals Morbidity and Mortality After Major Hepatic Resection in Cirrhotic Patients with Hepatocellular Carcinoma

HPB Surgery ◽  
1988 ◽  
Vol 1 (1) ◽  
pp. 45-56 ◽  
Author(s):  
Naofumi Nagasue ◽  
Hirofumi Yukaya ◽  
Hitoshi Kohno ◽  
Yu-Chung Chang ◽  
Teruhisa Nakamura
Keyword(s):  
Hepatocellular Carcinoma ◽  
Postoperative Complications ◽  
Liver Failure ◽  
Hepatic Resection ◽  
Survival Rates ◽  
Postoperative Liver Failure ◽  
Major Hepatic Resection ◽  
Class B ◽  
Left Lobectomy ◽  
Left Lateral Segmentectomy

Major hepatic resection was carried out on 23 adult patients with hepatocellular carcinoma (HCC) and underlying cirrhosis of the liver (macronodular in six cases, micronodular in 11, and mixed type cirrhosis in six). Pre-operative liver functional state was Child's class A in 19, class B in three, and class C in one. The operations performed were extended right lobectomy in four patients, right lobectomy in 10, left lobectomy in one, and left lateral segmentectomy in eight. Fifteen postoperative complications were found in 10 patients, five of whom had duplicated complications and finally died of liver failure 15–65 days after operation. In three of those five patients, other complications (hemorrhagic shock in two and portal thrombosis in one) had preceded liver failure. Eighteen patients tolerated the resection and were discharged from hospital. However, among 13 noncirrhotic patients with HCC who had undergone major hepatic resection during the same period of time, only two had postoperative complications and all patients were discharged from hospital. The 1-, 2- and 3-year survival rates in the 23 cirrhotics were 60.9%, 37.5% and 24.9% respectively, whereas the 1–5-year survival rates were all 61.5% in the 13 noncirrhotics. Thus, major hepatic resection may be indicated in selected patients with HCC and associated cirrhosis, but meticulous managements during and after operation are mandatory to prevent fatal postoperative liver failure.

scholarly journals Prognostic Factors After Hepatic Resection for Hepatocellular Carcinoma Associated With Child-Turcotte Class B and C Cirrhosis

1999 ◽  
Vol 229 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Naofumi Nagasue ◽  
Hitoshi Kohno ◽  
Mitsuo Tachibana ◽  
Akira Yamanoi ◽  
Haruki Ohmori ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Hepatic Resection ◽  
Class B

scholarly journals Long-Term Outcomes of Hepatic Resection versus Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Toshimi Kaido ◽  
Satoshi Morita ◽  
Sachiko Tanaka ◽  
Kohei Ogawa ◽  
Akira Mori ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Propensity Score ◽  
Hepatic Resection ◽  
Propensity Score Matching ◽  
Odds Ratio ◽  
Living Donor ◽  
Survival Rates ◽  
Controlled Study ◽  
Recurrence Rates

Hepatic resection (HR) and liver transplantation (LT) are surgical treatment options for hepatocellular carcinoma (HCC). However, it is clinically impossible to perform a randomized, controlled study to determine the usefulness of these treatments. The present study compared survival rates and recurrence rates of HR versus living donor LT (LDLT) for HCC by using the propensity score method. Between January 1999 and August 2012, 936 patients (732 HR, 204 LDLT) underwent surgical therapy for HCC in our center. Using the propensity score matching, 80 well-balanced patients were defined. The 1- and 5-year overall survival rates were 90% and 53% in the HR group and 82% and 63% in the LT group, respectively. They were not significantly different between the two groups. The odds ratio estimated using the propensity score matching analysis was 0.842 (P=0.613). The 1- and 5-year recurrence rates were significantly lower in the LT group (9% and 21%) than in the HR group (43% and 74%) (P<0.001), and the odds ratio was 0.214 (P=0.001). In conclusion, HR should be considered a valid alternative to LDLT taking into consideration the risk for the living donor based on the results of this propensity score-matching study.

Relationship between platelet count and hepatic failure and residual liver regeneration after hemihepatectomy in patients with hepatitis B-related primary hepatocellular carcinoma

2019 ◽  
Author(s):  
Chuhui Ye ◽  
Banghao Xu ◽  
Kaiyi Lu ◽  
Tingting Lu ◽  
Ling Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Hepatitis B ◽  
Liver Failure ◽  
Liver Regeneration ◽  
Liver Volume ◽  
Primary Hepatocellular Carcinoma ◽  
Postoperative Liver Failure ◽  
Regeneration Rate ◽  
Significant Difference

Abstract Objective A retrospective analysis of the influences of platelet (PLT) counts on liver failure and liver regeneration in patients with primary hepatocellular carcinoma (HCC) provides a treatment strategy for clinical prevention and treatment of postoperative liver failure and residual liver regeneration. Method The clinical data of 111 patients with a background of hepatitis B virus infection and who underwent (expanded) half liver resection at the First Affiliated Hospital of Guangxi Medical University from June 2012 to June 2017 were collected and statistically analyzed. Results　On the basis of the International Study Group of Liver Surgery liver failure-grading standards and Dino–Clavien postoperative complication criteria, the incidence of grade B and above liver failure was 55%, and complication II level and above was 47.5% in the PLT decline group after semihepatectomy. The incidence rates in the normal group were 26.8% and 23.9%. A statistically significant difference was determined in the two groups (P1=0.003, P2 = 0.011). The average volumes of liver hyperplasia (residual liver volume (RLV)80.4 days − RLV) in the PLT decline and normal groups were 132.09 ± 61.89 cm3 and 190.89 ± 91.98c cm3, respectively; the average rates of hyperplasia ((RLV80.4days−RLV)/RLV) were 16.59%± 7.36% and 24.78% ± 10.82%. The difference between the two groups was statistically significant (PProliferation = 0.001, PProliferation rate = 0.001). Univariable and multivariable logistic regression analyses of postoperative liver failure grade and proliferation rate in patients who underwent semihepatectomy suggested that the decrease in postoperative PLT count (PLT < 125 × 109/L) might be an independent risk factor of severe posthepatectomy liver failure (PHLF) (PHLF-B or above) and residual liver regeneration rate for patients with primary HCC after half liver resection. No death occurred. Conclusions A correlation existed between PLT count and postoperative PHLF or liver regeneration. Monitoring PLT counts after liver resection may help us predict the suffering from PHLF-B or above and severe postoperative complications.

Liver failure after major hepatic resection

2008 ◽  
Vol 16 (2) ◽  
pp. 145-155 ◽  
Author(s):  
Giuseppe Garcea ◽  
G. J. Maddern
Keyword(s):  
Liver Failure ◽  
Hepatic Resection ◽  
Major Hepatic Resection

Therapeutic Efficacy of Transcatheter Arterial Chemoembolization as Compared With Hepatic Resection in Hepatocellular Carcinoma Patients With Compensated Liver Function in a Hepatitis B Virus–Endemic Area: A Prospective Cohort Study

2002 ◽  
Vol 20 (22) ◽  
pp. 4459-4465 ◽  
Author(s):  
Hyo-Suk Lee ◽  
Kang Mo Kim ◽  
Jung-Hwan Yoon ◽  
Tae-Rim Lee ◽  
Kyung Suk Suh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Rate ◽  
Liver Function ◽  
Hepatic Resection ◽  
Transcatheter Arterial Chemoembolization ◽  
Survival Rates ◽  
Tumor Stage ◽  
Significant Difference ◽  
Tace Group ◽  
Arterial Chemoembolization

PURPOSE: Identifying a special subgroup of hepatocellular carcinoma (HCC) patients who may benefit from transcatheter arterial chemoembolization (TACE) when compared with the standard treatment of hepatic resection (HR) warrants research in Asian countries. PATIENTS AND METHODS: From January 1993 to December 1994, 182 patients with operable HCC (Child-Pugh class A and International Union Against Cancer [UICC] stage T1-3N0M0) were enrolled. After initial TACE and lipiodol computed tomography, 91 received HR and 91, who refused the operation, received repeated sessions of TACE. After stratification according to the tumor stage (UICC and Cancer of the Liver Italian Program [CLIP]) and lipiodol retention pattern, the survival rates of the two treatment groups were compared. The median follow-up period was 83 months. RESULTS: As of December 31, 2000, 48 patients who underwent HR and 68 patients who underwent TACE had died. In a subgroup analysis according to tumor stage, the HR group survival rate was significantly higher than the TACE group in both UICC T1-2N0M0 (P = .0058) and CLIP 0 (P = .0027) subgroups. However, there was no significant difference in either UICC T3N0M0 (P = .7512) or CLIP 1-2 (P = .5366) subgroups. Even in patients with UICC T1-2N0M0 HCC, when lipiodol was compactly retained, the survival rate of the HR group was comparable to that of the TACE group (P = .0596). CONCLUSION: TACE proved to be as effective as HR in the subpopulations with UICC T3N0M0 or CLIP 1-2 HCC and adequate liver function, and even with UICC T1-2N0M0 HCC when lipiodol was compactly retained in the tumor. In such cases, the choice of treatment modality between TACE and HR may be left to the patient’s preference.

scholarly journals CORRELATION BETWEEN POSTOPERATIVE COMPLICATIONS AND LIVER FAILURE IN PATIENTS WITH HEPATOCELLULAR CARCINOMA

1990 ◽  
Vol 51 (9) ◽  
pp. 1907-1912
Author(s):  
Masato SAKON ◽  
Koji UMESHITA ◽  
Morito MONDEN ◽  
Mitsukazu GOTOH ◽  
Kenji KOBAYASHI ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Postoperative Complications ◽  
Liver Failure
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