Resection of hepatocellular carcinoma after transcatheter arterial embolization. Reevaluation of the advantages and disadvantages of preoperative embolization
T. L. Hwang, M. F. Chen, T. Y. Lee, T. J. Chen, D. Y. Lin and Y. F. Liaw
Hepatocellular carcinomas (HCCs) were resected in eight patients who had
preoperative transcatheter arterial embolization (TAE) and in 25 patients
without preoperative TAE. Three patients in the former group had ruptured
HCCs before operation. Two of the former group and three of the latter
group were found to have recurrences after a follow-up of 1 1/2 years.
Although preoperative TAE resulted in significantly increased tumor
necrosis, it increased the risk of gangrenous change of the gallbladder,
induced adhesion of the hepatoduodenal ligament, and was not effective in
reducing operative blood loss or operative time if the vessel selected for
TAE was inadequate. Pathologic examination revealed tumor emboli still
existing in the intrahepatic veins. Daughter nodules and capsular invasion
by tumor cells were not affected by TAE. Transcatheter arterial
embolization seems to be effective in controlling bleeding from ruptured
HCC prior to staged resection of the tumor.
