Clinical significance of removal of tumor thrombi in the main portal vein in patients with hepatocellular carcinoma |
| |
Authors: | Ming-Hui Mei Jian-Hua Tang Qian Chen Xian-Lan Zhang Jing-Hong Yang Jing Xu Fang Lu Wei Deng |
| |
Affiliation: | 1. Department of Hepato-Biliary Surgery Affiliated Hospital, Guilin Medical College, 95 Lequn Road, 541001, Guilin, PRC
|
| |
Abstract: | Twenty-two patients with portal vein tumor thrombi secondary to hepatocellular carcinoma were studied to evaluate the effectiveness of diagnostic and treatment procedures. B-mode ultrasonography is a simple and accurate means for the detection of tumor thrombus in the portal vein. All of the 22 patients were correctly diagnosed by this method, which should be used as the initial screening procedure in such patients. Fourteen of the 22 patients underwent surgical procedures, including embolectomy from the portal trunk; removal of the tumor thrombi combined with hepatectomy or through the rechanneled umbilical vein; and operative transcatheter arterial chemotherapy. The other 8 patients were treated by transcatheter arterial embolization or were not treated. The surgical treatment effectively prevented acute variceal bleeding in the patients who underwent the procedures successfully. The mean value of the portal venous pressure was reduced from 46 cmH2O to 32 cmH2O after the surgery. As a result of the effective portal decompression, the patients in the surgical group had a better prognosis and longer mean survival than the others. Our study suggests that portal vein tumor thrombus is not an absolute contraindication for surgery, and that accurate detection and prompt treatment are the keys to the achievement of better clinical results. |
| |
Keywords: | hepatocellular carcinoma (HCC) portal vein tumor thrombi (PVTT) portal hypertension embolectomy |
本文献已被 SpringerLink 等数据库收录! |