Surgical Treatment of Ruptured Hepatocellular Carcinoma

Kim, Ki Doong; Lee, Dong Shik; Yun, Sung Su; Kim, Hong Jin

Abstract

BACKGROUND/AIMS: Spontaneous rupture causing massive hemoperitoneum is a potentially life-threatening complication of hepatocellular carcionma (HCC). Hepatic resection provides the only hope of cure for patients with a ruptured HCC. So we reviewed our clinical experience with surgical treatments for ruptured HCC.
METHODS
Between October 1990 and April 2003, twelve cases were treated with liver resection for ruptured HCC at our department. The clinical records were reviewed retrospectively.
RESULTS
Twelve patients underwent hepatectomy. Ages ranged from 44 to 69 years with a mean age of 54.4 years, and sex ratio was 5:1 with a male dominence. Liver cirrhosis was presented in 9 cases (75%). 9 cases of them underwent staged hepatectomy; the other 3 underwent emergency hepatectomy. Three patients were treated by transcatheter arterial embolization (TAE) before staged hepatectomy. The median survival time were 40 (4~2) months, and overall 1-year and 3-year cumulative survival rates were 81% and 36%.
CONCLUSION
Surgical resection is the only procedure associated with long-term survival for resectable ruptured HCC with good liver function. With or without preoperative TAE, elective hepatectomy is a rational treatment for patients with ruptured HCC.