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The benefit of curative liver resection with a selective bile duct preserving approach for hepatocellular carcinoma with macroscopic bile duct tumor thrombus

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Hepatobiliary Surgery and Nutrition 2020年第6期9卷 729-738页

作者： Anon Chotirosniramit Akkaphod Liwattanakun Sunhawit Junrungsee Wasana Ko-iam trichak sandhu Worakitti Lapisatepun Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryFaculty of MedicineChiang Mai University HospitalChiang MaiThailand

Background:Hepatocellular carcinoma(HCC)presenting with macroscopic bile duct tumor thrombus(BDTT)is an uncommon *** role of a curative hepatic resection and associated long-term outcomes remain *** addition the necessity for bile duct resection is still *** aim of this study was to evaluate outcomes of hepatectomy with a selective bile duct preservation approach for HCC with BDTT in comparison to outcomes without ***:A total of 22 HCC with BDTT patients who had undergone curative hepatic resection with a selective bile duct preservation approach at our institute were retrospectively *** were compared to group of 145 HCC without BDTT *** impact of curative surgical resection and BDTT on clinical outcomes and survival after surgical resection were ***:All HCC with BDTT cases underwent major hepatectomy vs.32.4%in the comparative *** duct preservation rate was 56.5%.The 1-,3-and 5-year survival rates of HCC with BDTT patients in comparison to the HCC without BDTT group were 81.8%,52.8%and 52.8%vs.73.6%,55.6%and 40.7%(P=0.804)*** resection margin,tumor size≥5 cm and AFP≥200 IU/mL were significant risk factors regarding overall ***,it is unclear whether presence of a bile duct tumor thrombus has an adverse impact on either recurrence free survival or overall ***:Bile duct obstruction from tumor thrombus did not necessarily indicate an advanced form of *** size and AFP had greater impact on long-term outcomes than bile duct tumor *** liver resection with a selective bile duct preserving approach in HCC with BDTT can achieve favorable outcomes comparable to those of HCC without BDTT in selected patients.

关键词： Hepatocellular carcinoma(HCC) bile duct tumor thrombus(BDTT) bile duct preserve outcomes

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