Emergency laparoscopic resection of spontaneous rupture of hepatocellular carcinoma: A case report

Khairuddin, Allim; Ong, Guang Hong; Tan, Jun Sam; Johan, Syamim; Hoe, Vee Chuan; Sharif, Mohd Sharifudin; Hayati, Firdaus

doi:10.1016/j.ijscr.2019.11.055

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Beside the different number of enrolled patients, different criteria for patient selecting may also relate to the different results. It has been reported that minimally invasive treatment could be used for the tumor rupture ( 27 - 29 ) because it is able to alleviate the postoperative liver function. Although the data of long-term follow-up and large sample are absent, laparoscopic hepatectomy should be considered during emergency when the RHCC patient with less bleeding (stable vital signs) and small tumor located peripherally, since the treatment with a minimal invasion and shorter operation time can maximize the benefit of the patient.…”

Section: Discussionmentioning

confidence: 99%

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Wang¹,

Meng²,

Chen³

et al. 2022

Hepatobiliary Surg Nutr

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Background: This study aims to find out the possible optimal therapy and assess the prognosis properly for patient with spontaneous rupture of hepatocellular carcinoma (HCC).Methods: Propensity score matching (PSM) analysis was used to study the data from 325 patients with ruptured HCC (RHCC) and 2,291 patients with non-RHCC.Results: The incidence and hospital mortality of RHCC were 5.1% and 0.8% respectively, with a median overall survival (OS) time of 17 months. There was no difference between ruptured and non-RHCC patients undergoing conservation treatment in terms of OS. Trans-arterial embolization (TAE) was carried out in 69 (21.2%) cases with RHCC, with a median OS of 7 months, which was no difference from that of non-RHCC (pre-and post-PSM). One hundred and sixty-nine (52.0%) RHCC cases underwent one-stage hepatectomy, with a median OS and disease-free survival (DFS) of 30 and 6 months respectively, which were shorter than that of non-RHCC (post-PSM). TAE plus two-stage hepatectomy was performed in 30 RHCC cases, with a median OS and DFS of 28 and 10 months respectively; these outcomes were better than that from RHCC patients undergoing TAE alone or one-stage hepatectomy (post-PSM), which were no difference from that of non-RHCC patients undergoing hepatectomy. The risk of death for RHCC patient undergoing one-stage hepatectomy is 1.545 times higher than that of one undergoing TAE + two-stage hepatectomy.Conclusions: TAE plus two-stage hepatectomy might be the optimal treatment for RHCC patient. Under the premise of the same pathological properties, there is no difference in prognosis between ruptured and non-RHCC patients if the therapy is appropriate.

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Section: Discussionmentioning

confidence: 99%

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Wang¹,

Meng²,

Chen³

et al. 2022

Hepatobiliary Surg Nutr

View full text Add to dashboard Cite

show abstract

“…2,4,8,20,21 Although the laparoscopic approach to liver resection is well accepted in HCC, its use in ruptured cases has not been well defined. 22 In our cohort, more than half of the patients were initially managed with TAE, and half of these underwent subsequent treatment either by staged liver resection or other therapies, whereas the remaining patients did not receive any subsequent treatments. Onethird of our cohort was managed with immediate surgical intervention.…”

Section: Discussionmentioning

confidence: 94%

Spontaneous Rupture of Hepatocellular Carcinoma: New Insights

Obeidat

2022

Journal of Clinical and Experimental Hepatology

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Background: Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially fatal complication and the third leading cause of death in patients with HCC after tumor progression and liver failure. Previous studies suggested that improved HCC surveillance has decreased the incidence of rupture. This study aims to characterize patients with ruptured HCC over time and identify predictors of rupture. Methods: We retrospectively reviewed a prospectively collected database of 1451 HCC patients to identify cases with rupture and predictors of rupture. Data were divided into three 9-year eras to compare and trend patient/tumor characteristics and rupture. Results: Fifty-seven patients (3.9%) presented with spontaneous HCC rupture and the following characteristics: mean age 62.6 years, 73.7% males, 41% cirrhosis, and mean tumor size of 8.0 cm. On multivariate analyses, predictors of rupture included obesity, tumor >5 cm, and single tumors, whereas the presence of cirrhosis was a negative predictor for rupture.Across three eras, there were changes in disease etiology and decreases in tumor size, and more HCCs were found with surveillance. However, more patients were noncirrhotic, and the incidence of spontaneous rupture was unchanged over time. Conclusion: Despite improved early detection of HCC over time, the incidence of rupture has been unchanged. The persistent incidence of rupture may possibly be attributed to increasing proportion of fatty liver-related HCC patients who lack traditional risk factors for surveillance and may not have cirrhosis. Better identification of fatty liver disease and determining which patients need HCC surveillance may be needed in the future to prevent spontaneous rupture.

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Emergency laparoscopic resection of spontaneous rupture of hepatocellular carcinoma: A case report

Cited by 2 publications

References 15 publications

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Spontaneous Rupture of Hepatocellular Carcinoma: New Insights

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