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- Title
Impact of Severe Oesophagogastric Varices on Liver Resection for Hepatocellular Carcinoma in Cirrhotic Patients.
- Authors
Liu, Hsiao-Tien; Cheng, Shao-Bin; Wu, Cheng-Chung; Yeh, Hong-Zen; Chang, Chi-Sen; Wang, John
- 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.
- Subjects
ESOPHAGEAL varices; ESOPHAGOGASTRIC junction; LIVER cancer; LIVER surgery; CIRRHOSIS of the liver
- Publication
World Journal of Surgery, 2015, Vol 39, Issue 2, p461
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-014-2811-9