Combined Operations For Patients With Hepatic Cancers Complicated With Portal Hypertension (13 Cases Reported)

Objective:To investigate the clinical effect of combined operations for patients with hepatic cancers complicated with portal hypertension.Methods:The clinical data of 13 patients with HCC complicated with liver cirrhosis and portal hypertension were analyzed retrospectively.Results:In the 13 cases,10 underwent hepatectomy combined with splenectomy, 2 underwent radiofrequence ablation interoperation combined with splenectomy, the other one underwent both hepatectomy and radiofrequence ablation interoperation combined with splenectomy,and 5 of them underwent esophageal devascularization in addition. The symptoms of hypersplenism were disappeared after operation, and there were no tumor recurrence during the 1 to 3 months after operation in 12 cases of them, except for one cases of death. The level of alpha-fetoprotein became lower significantly after 4 to 6 moths of the operation in 9 cases who had a high alpha-fetoprotein before. The post-operative complication developed in 5 cases, including moderate-volume ascites in 2 cases, intraperitoneal hemorrhage in 1 case, lung infection, inducing hepatic failure and eventually death in 1 case, upper alimentary tract bleeding(no bleeding before operation) in 1 case, and convalescence-discharge in the other 8 cases.Conclusion:It is safe and effective to perform hepatectomy or radiofrequence ablation interoperation combined with splenectomy and esophageal devascularization in patients with HCC complicated with liver cirrhosis and portal hypertension. Strict selection of surgical indications must be done necessary. A careful perioperative management is very important for short-term curative effect.