Despite unquestionable progress has been made inresection of small and large hepatocellular carcinoma'(HCC),the dismal outcome of unresectable HCC remains a great challenge.Fortunately,the progress of multidiscipl...Despite unquestionable progress has been made inresection of small and large hepatocellular carcinoma'(HCC),the dismal outcome of unresectable HCC remains a great challenge.Fortunately,the progress of multidisciplinary approach,particularly with new treatment modalities,has provided a new hope for unresectable HCC.This paper reports 477 patients with surgically verified unresectable HCC treated by different modalities, sequential resection was done in 55 patients(11.5%)due to marked shrinkage of the tumor.Patients treated with hepatic artery ligation(HAL),cannulation with infusion (HAI)and plus intraarterial targeting therapy(131I-antiHCC Ferritin IgG,131I-antiHCC monoclonal antibody,or 131I-Lipiodol)has higher sequential resection rate(33. 0%,31/94)when compared with other combination treatment(HAL+HAI,HAL+HAI+radiotherapy,11.7% ,22/188),and single treatment group(Cryosurgery,HAL,or HAI,1.0%,2/195). The combination of targeting therapy played an important role to the increasing number of sequential resection during 1978 through 1992.The 5-year survival of the 55 patients with sequential resection was as nigh as 60.8%.By the end of June 1993,13 patients survived more than 5 years, the longest being 15 years.展开更多
We present a video case of a 51-year-old man admitted to our surgical and liver transplantation unit for hepatocellular cancer（HCC）. Patient has a HCV cirrhosis with portal hypertension and esophageal varices F1. Ch...We present a video case of a 51-year-old man admitted to our surgical and liver transplantation unit for hepatocellular cancer（HCC）. Patient has a HCV cirrhosis with portal hypertension and esophageal varices F1. Child Pugh score was B7 and model of end staged liver disease（MELD） was 11. Body mass index（BMI） was 26.7 and ASA score was 2. No previous abdominal surgery. According with our multidisciplinary group we suggest a laparoscopic left lobectomy for the patient. Pringle manoeuvre was not performed. Operation time was 193 min and blood loss estimation was 100 cc. No transfusion was required. Postoperative course was uneventful, grade I of Clavien-Dindo Classification. Patient was discharged in day 8. In our experience laparoscopic resection in cirrhotic liver should be performed in selected patients and in an experienced team.展开更多
文摘Despite unquestionable progress has been made inresection of small and large hepatocellular carcinoma'(HCC),the dismal outcome of unresectable HCC remains a great challenge.Fortunately,the progress of multidisciplinary approach,particularly with new treatment modalities,has provided a new hope for unresectable HCC.This paper reports 477 patients with surgically verified unresectable HCC treated by different modalities, sequential resection was done in 55 patients(11.5%)due to marked shrinkage of the tumor.Patients treated with hepatic artery ligation(HAL),cannulation with infusion (HAI)and plus intraarterial targeting therapy(131I-antiHCC Ferritin IgG,131I-antiHCC monoclonal antibody,or 131I-Lipiodol)has higher sequential resection rate(33. 0%,31/94)when compared with other combination treatment(HAL+HAI,HAL+HAI+radiotherapy,11.7% ,22/188),and single treatment group(Cryosurgery,HAL,or HAI,1.0%,2/195). The combination of targeting therapy played an important role to the increasing number of sequential resection during 1978 through 1992.The 5-year survival of the 55 patients with sequential resection was as nigh as 60.8%.By the end of June 1993,13 patients survived more than 5 years, the longest being 15 years.
文摘We present a video case of a 51-year-old man admitted to our surgical and liver transplantation unit for hepatocellular cancer（HCC）. Patient has a HCV cirrhosis with portal hypertension and esophageal varices F1. Child Pugh score was B7 and model of end staged liver disease（MELD） was 11. Body mass index（BMI） was 26.7 and ASA score was 2. No previous abdominal surgery. According with our multidisciplinary group we suggest a laparoscopic left lobectomy for the patient. Pringle manoeuvre was not performed. Operation time was 193 min and blood loss estimation was 100 cc. No transfusion was required. Postoperative course was uneventful, grade I of Clavien-Dindo Classification. Patient was discharged in day 8. In our experience laparoscopic resection in cirrhotic liver should be performed in selected patients and in an experienced team.
