Erschienen in:
01.02.2015 | Original Scientific Report
Impact of Severe Oesophagogastric Varices on Liver Resection for Hepatocellular Carcinoma in Cirrhotic Patients
verfasst von:
Hsiao-Tien Liu, Shao-Bin Cheng, Cheng-Chung Wu, Hong-Zen Yeh, Chi-Sen Chang, John Wang
Erschienen in:
World Journal of Surgery
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Ausgabe 2/2015
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Abstract
Background
The aim of the present study was to clarify both short-term and long-term results of patients with concomitant hepatocellular carcinoma (HCC) and high-risk oesophagogastric varices (OGV).
Methods
This retrospective study identified 927 cirrhotic patients who underwent curative resection of HCC between 1995 and 2012 in single institution. Patients were separated into 3 groups (A, B, and C) according to general rules for recording endoscopic findings of oesophagogastric varices proposed in Japan in 1991. Groups A, B, and C consisted of patients without OGV (F0), patients with mild to moderate OGV (F1 to F2), and patients with high-risk OGV (F3 and/or red color sign), respectively. All patients in group C underwent prophylactic endoscopic variceal ligation/sclerotherapy. Post-operative complications, mortality, overall survival, and disease-free survival were compared among 3 groups.
Results
No patient had post-operative variceal bleeding. Complication rates of Clavien-Dindo grade II to V in three groups were 13.6, 14.0, and 6.9 %, respectively (P > 0.05). Operative mortality, 5-year overall survival rate, and disease-free survival rate among the 3 groups were not significantly different (P > 0.05).
Conclusions
Prophylactic endoscopic variceal ligation/sclerotherapy effectively prevented from post-operative variceal bleeding in patients with high-risk OGV. Operative mortality, major morbidity, and survival of patients with high-risk OGV were similar to those of patients without OGV or those with mild OGV. Liver resection remains a feasible choice for cirrhotic patients with concomitant HCC and high-risk OGV.