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Reevaluation of the Advantages and Disadvantages of Preoperative Embolization

Tsann-Long Hwang, MD; Miin-Fu chen, MD; Tse-Yu Lee, MD; Tong-Jong chen, MD; Deng-Yn Lin, MD; Yun-Fan Liaw, MD

Arch Surg. 1987;122(7):756-759.

Abstract
• 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 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.

(Arch Surg 1987;122:756-759)

Author Affiliations
From the Departments of Surgery (Drs Hwang and M.-F. Chen), Radiology (Dr Lee), and Pathology (Dr T.-J. Chen) and Liver Unit (Drs Lin and Liaw), Lin Kou Medical Center, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.

Footnotes
Accepted for publication June 3, 1986.

Reprint requests to Department of Surgery, LinKou Medical Center, Chang Gung Memorial Hospital, 5, Fu-Hsing St, TaoYuan Hsien, Taiwan, ROC (Dr M.-F. Chen).

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