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Impact of Severe Oesophagogastric Varices on Liver Resection for Hepatocellular Carcinoma in Cirrhotic Patients

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Abstract

Background

The aim of the present study was to clarify both short-term and long-term results of patients with concomitant hepatocellular carcinoma (HCC) and high-risk oesophagogastric varices (OGV).

Methods

This retrospective study identified 927 cirrhotic patients who underwent curative resection of HCC between 1995 and 2012 in single institution. Patients were separated into 3 groups (A, B, and C) according to general rules for recording endoscopic findings of oesophagogastric varices proposed in Japan in 1991. Groups A, B, and C consisted of patients without OGV (F0), patients with mild to moderate OGV (F1 to F2), and patients with high-risk OGV (F3 and/or red color sign), respectively. All patients in group C underwent prophylactic endoscopic variceal ligation/sclerotherapy. Post-operative complications, mortality, overall survival, and disease-free survival were compared among 3 groups.

Results

No patient had post-operative variceal bleeding. Complication rates of Clavien-Dindo grade II to V in three groups were 13.6, 14.0, and 6.9 %, respectively (P > 0.05). Operative mortality, 5-year overall survival rate, and disease-free survival rate among the 3 groups were not significantly different (P > 0.05).

Conclusions

Prophylactic endoscopic variceal ligation/sclerotherapy effectively prevented from post-operative variceal bleeding in patients with high-risk OGV. Operative mortality, major morbidity, and survival of patients with high-risk OGV were similar to those of patients without OGV or those with mild OGV. Liver resection remains a feasible choice for cirrhotic patients with concomitant HCC and high-risk OGV.

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Acknowledgments

The authors thank the Department of Medical Research of Taichung Veterans General Hospital for statistical assistance.

Conflict of interest

Potential and real conflicts of interest: none declared.

Author information

Authors and Affiliations

  1. Department of Surgery, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan, Roc

    Hsiao-Tien Liu, Shao-Bin Cheng & Cheng-Chung Wu

  2. Department of Surgery, Chung-Shan Medical University, Taichung, Taiwan, Roc

    Hsiao-Tien Liu, Shao-Bin Cheng & Cheng-Chung Wu

  3. Department of Surgery, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Cheng-Chung Wu

  4. Department of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan

    Hong-Zen Yeh & Chi-Sen Chang

  5. Departments of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan

    John Wang

Authors
  1. Hsiao-Tien Liu
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  2. Shao-Bin Cheng
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  3. Cheng-Chung Wu
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  4. Hong-Zen Yeh
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  5. Chi-Sen Chang
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  6. John Wang
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Corresponding author

Correspondence to Cheng-Chung Wu.

Additional information

Hsiao-Tien Liu and Shao-Bin Cheng equally contributed to this article.

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Liu, HT., Cheng, SB., Wu, CC. et al. Impact of Severe Oesophagogastric Varices on Liver Resection for Hepatocellular Carcinoma in Cirrhotic Patients. World J Surg 39, 461–468 (2015). https://doi.org/10.1007/s00268-014-2811-9

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  • DOI: https://doi.org/10.1007/s00268-014-2811-9

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