Therapeutic problems in 15 patients with partially resected hepatocellular carcinomas were studied.
Significant differences in preoperative values of ICG-R15, OGTT linearity index, serum platelet counts and postoperative score of hepatic function were noted between patients with and without esophageal varices. Three patients who underwent partial hepatectomies combined with non shunting operations for esophageal varices were complicated by postoperative hepatic failure. For the limitation of anatomical aspect, 4 patients were not curatively resected due to TW factor.
These results suggested that simultaneous surgical treatment for esophageal varices complicated with hepatocellular carcinoma should cause some damages to patients who were indicated partial hepatectomies, therefore preoperative endoscopic sclerotherapy should be first selected for these patients. For the local recurrence of partially resected hepatocellular carcinoma, propylactic portal infusion chemotherapy is considered to be a useful postoperative thrapy.