[Surgical intervention of hepatocellular carcinoma with bile duct thrombi].

OBJECTIVES

To summarize the experience of surgical intervention for hepatocellular carcinoma (HCC) with bile duct thrombi (BDT), and to evaluate the influence on prognosis.

METHODS

From 1994 to 2002, 15 patients with HCC and BDT who underwent surgical intervention were retrospectively analyzed.

RESULTS

The operative procedures included hepatectomy with removal of BDT (n = 7), hepatectomy combined with extrahepatic bile duct resection (n = 4), thrombectomy through choledochotomy (n = 3), and piggy-back orthotopic liver transplantation (n = 1). The 1- and 3-year survival rates were 73.3% and 40%, respectively. Two patients survived over 5 year. The survival rate of patients with portal vein invasion was significantly lower than that of patients without portal vein invasion (P < 0.05).

CONCLUSIONS

Surgical intervention was effective for patients with HCC and BDT. Operation after recurrence can prolong the survival time. Liver transplantation is a new operative procedure worthy of study.