(Fig. 1). The preoperative dynamic CT scan also revealed an excessively large right branch of the portal vein and complete absence of the left branch of the portal vein (Fig. 2). A HIDA scan showed no evidence of biliary obstruction. Formal left hepatectomy with biliary-enteric anastomosis was planned.At operation, the left liver was atrophic and contained multiple cysts. The left intrahepatic ductal system was dilated in a cystic manner down to an anastomosis to a Roux-en-Y loop of

Background: The survival of children with recurrent hepatoblastoma (RHB) is still unsatisfactory and the treatment for relapsed patients is challenging. Purpose: To compare short-term results between open liver resection (OLR) and percutaneous thermal ablation (TA) in the treatment of RHB and provide evidence to support the treatment options for such patients. Methods: A retrospective data of 21 patients with RHB in two Chinese centers were analyzed from January 2013 to May 2019. The baseline indicators and clinical effect of the two groups of children were compared.Results: There was no statistical difference in baseline indicators between the two groups of children, and complete remission (CR) was achieved after comprehensive treatment. The median follow-up time was 30 months (IQR 38.5 months) in the TA group, and 23 months (IQR 21.7 months) in OLR group (p ¼ .57). The 2-year OS rates were 92.3% in the percutaneous TA group and 87.5% in the OLR group (p ¼ .68, HR ¼ 1.6, 95% confidence interval [CI]: 0.2-12.4). The 2-year EFS rates were 66.7%, in the TA group and 50.0% in the OLR group (p ¼ .51, HR ¼ 0.6, 95% CI: 0.2-2.6). Compared with the OLR group, TA group had shorter operation time (3.5 ± 1.8 vs. 0.5 ± 0.1, p < .001) and postoperative hospitalization time (11.8 ± 3.0 vs. 9.5 ± 6.8 d, p ¼ .045). No major complications occurred in both groups. Conclusions: Ultrasound-guided percutaneous TA for RHB is a safe and effect treatment option for children. It has comparable effect with surgery within 2 years after treatment. Particularly, due to its minimally invasive advantage, it needs shorter operation and hospitalization time. Percutaneous ablation may be an alternative minimally invasive treatment for RHB children.