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[Hepatocellular carcinoma. Our experience]
A Catona1, E Armeni, M Gossenberg
1Divisione di Chirurgia, USSL n. 77, Pavia.
Minerva Chirurgica
|December 1, 1994
Summary
This study on hepatocarcinoma in cirrhosis found that restricted hepatic resection and Port-a-cath implantation for chemotherapy offer good outcomes. These surgical innovations minimize damage to liver function, improving patient survival rates.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Hepatocellular carcinoma (HCC) in patients with cirrhosis presents significant treatment challenges.
- Managing HCC requires balancing tumor removal with preserving critical liver function.
Purpose of the Study:
- To evaluate the safety and efficacy of restricted hepatic resection for HCC in cirrhotic patients.
- To assess the utility of Port-a-cath implantation for intra-arterial chemotherapy in unresectable HCC cases.
Main Methods:
- Retrospective analysis of 29 patients with HCC and cirrhosis from June 1991 to February 1993.
- 17 patients underwent restricted hepatic resection (1 cm margin) for unifocal/superficial tumors (Child A/B).
- 12 patients received Port-a-cath for hepatic artery chemotherapy due to multifocal disease or Child C function.
Main Results:
- No postoperative deaths occurred in either group.
- All patients remained alive at the end of the study period.
- Complications included manageable ascites and moderate pleuritis.
Conclusions:
- Restricted hepatic resection preserves liver functional reserve in cirrhotic patients with HCC.
- Port-a-cath implantation enables effective chemotherapy for unresectable HCC, reducing operative mortality.
- Accurate preoperative assessment and tailored surgical approaches are crucial for favorable outcomes.