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Related Experiment Video

Updated: May 10, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
04:41

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

Published on: March 10, 2023

Partial hepatectomy for ruptured hepatocellular carcinoma.

T Yang1, Y F Sun, J Zhang

  • 1Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.

The British Journal of Surgery
|June 12, 2013
PubMed
Summary

Spontaneous rupture of hepatocellular carcinoma (HCC) predicts poorer survival after partial hepatectomy. However, surgical treatment for ruptured HCC is feasible and safe in selected patients, with similar outcomes for emergency versus staged procedures.

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Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Gastroenterology

Background:

  • Partial hepatectomy is a safe treatment for hepatocellular carcinoma (HCC).
  • Improvements in surgical techniques and perioperative care enhance safety, even for ruptured HCC.
  • Spontaneous rupture of HCC presents unique surgical challenges.

Purpose of the Study:

  • To compare outcomes of partial hepatectomy for ruptured versus non-ruptured HCC.
  • To evaluate the safety and efficacy of emergency versus staged hepatectomy for ruptured HCC.
  • To identify prognostic factors for survival after hepatectomy for ruptured HCC.

Main Methods:

  • A cohort of 1233 patients undergoing partial hepatectomy for HCC (2000-2009) was analyzed.
  • Patients were divided into ruptured and non-ruptured HCC groups.

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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
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Last Updated: May 10, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
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Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection

Published on: April 11, 2025

  • Ruptured HCC patients were further stratified into emergency and staged hepatectomy subgroups for comparison of mortality, morbidity, overall survival, and recurrence-free survival (RFS).

    • Main Results:

    • Spontaneous rupture independently predicted poorer overall survival (HR 1.54) and RFS (HR 1.75) after hepatectomy.
    • Morbidity and mortality rates were similar between ruptured and non-ruptured groups, and between emergency and staged subgroups.
    • While univariable analysis showed worse outcomes for ruptured and emergency groups, multivariable analysis found no significant difference in survival or RFS between emergency and staged hepatectomy for ruptured HCC.

    Conclusions:

    • Spontaneous HCC rupture is a significant predictor of poor long-term survival post-hepatectomy.
    • Partial hepatectomy is a viable, safe, and appropriate surgical option for selected patients with ruptured HCC.
    • Surgical timing (emergency vs. staged) did not significantly impact long-term outcomes in multivariable analysis.