Early outcome after hepatectomy for hepatocellular carcinoma: a retrospective study

Ezzat, Helmy; Eleneen, Ahmed Abu; Elghawalby, Ahmed; Edrees, Mahmoud; Attia, Mohamed

doi:10.4103/ejs.ejs_304_20

Early outcome after hepatectomy for hepatocellular carcinoma: a retrospective study

Authors

Abstract

Background data
One of the most common malignancies worldwide is hepatocellular carcinoma (HCC). The mainstay of HCC therapy is surgery. Liver transplantation and liver resection, with a 5-year survival of 60–80%, are considered the only curative treatment modalities and produce the highest performance for correctly chosen candidates. In noncirrhotic patients with HCC as well as in cirrhotic patients with strong or adequate hepatic reservoir, liver resection is approved as the first-line therapy.
Patients and methods
The research involved 243 cases that underwent HCC hepatectomy. Full history taking, detailed physical inspection, and regular laboratory investigations were done for all cases. Furthermore, for specific information of tumor expansion, preoperative computed tomography or MRI was performed.
Results
Morbidity was encountered in 114 (46.9%) cases in the current study. Internal hemorrhage was encountered in six (2.5%) cases, and five of them were managed by exploration, whereas the remaining case was managed by interventional radiology. Bile leakage was encountered in 13 (5.3%) cases; five cases were managed by endoscopic retrograde cholangiopancreatography, two cases were managed by ultrasound-guided tube drainage, and the other six cases resolved spontaneously. Postoperative liver cell failure was encountered in 96 (39.5%) cases. Besides, portal vein thrombosis was encountered in one (0.4%) case, and it was managed by conservative treatment. Early mortality was experienced in 10 (4.1%) cases in our study, and all these cases died owing to liver cell failure.
Conclusion
Respecting the principles of liver surgery, hepatic resection can be performed, even in cirrhotic patients, with acceptable morbidity and minimal mortality. The most common complication after hepatic resection, in our study group, was postoperative liver failure, which was mostly reversible.

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