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hepatocellular carcinoma with bile duct thrombosis

Arnaud Monier, Boris Guiu, Rafael Duran, Serge Aho, Pierre Bize, Pierre Deltenre, Vincent Dunet, Alban Denys
OBJECTIVES: To compare transarterial chemoembolization (TACE)-related hepatic toxicities of conventional TACE (cTACE) and drug-eluting beads TACE (DEB-TACE) in patients with intermediate-stage hepatocellular carcinoma. METHODS: In this retrospective study, 151 consecutive patients undergoing cTACE or DEB-TACE and MRI 3-6 weeks before and after therapy were included. Toxicity was assessed on imaging (global hepatic damages (GHD), overall biliary injuries, biliary cast, bile duct dilatation, intrahepatic biloma, portal thrombosis), and clinico-biological follow-ups...
July 19, 2016: European Radiology
Dai Hoon Han, Dong Jin Joo, Myoung Soo Kim, Gi Hong Choi, Jin Sub Choi, Young Nyun Park, Jinsil Seong, Kwang Hyub Han, Soon Il Kim
Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea...
September 2016: Yonsei Medical Journal
Jun Gao, Qingshuai Zhang, Jun Zhang, Jian Kong, Shaohong Wang, Xuemei Ding, Shan Ke, Wenbing Sun
Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) formation is a rare entity found microscopically in 1% to 9.2% of resected specimens. The ideal treatment for HCC is surgical resection. However, because of poor hepatic functional reserve in patients with HCC, most tumors are unresectable. Here, we report 2 cases of HCC with BDTT type III accompanied by hepatic dysfunction that were successfully treated with radiofrequency (RF) ablation. We used RF ablation as both a radical therapeutic method and an efficient way to control bleeding from the origin of BDTT after BDTT removal...
July 2015: Medicine (Baltimore)
Jong M Kim, Choon H D Kwon, Jae-Won Joh, Dong H Sinn, Jae B Park, Joon H Lee, Sung J Kim, Seung W Paik, Cheol K Park, Byung C Yoo
In patients with hepatocellular carcinoma (HCC), the presence of bile duct tumor thrombi (BDTT) in the major bile ducts indicates poor prognosis compared with that of HCC patients without BDTT. However, the prognostic significance of incidental microscopic BDTT in the peripheral bile ducts after curative liver resection is not known. We compared the outcomes of HCC patients with and without microscopic BDTT in the peripheral bile ducts who underwent hepatectomy.The electronic medical records of 31 patients with microscopic BDTT (BDTT group) were retrospectively reviewed...
February 2015: Medicine (Baltimore)
S Truant, O Scatton, S Dokmak, J-M Regimbeau, V Lucidi, A Laurent, R Gauzolino, C Castro Benitez, A Pequignot, V Donckier, C Lim, M-L Blanleuil, R Brustia, Y-P Le Treut, O Soubrane, D Azoulay, O Farges, R Adam, F-R Pruvot
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was recently developed to induce rapid hypertrophy and reduce post-hepatectomy liver failure in patients with insufficient remnant liver volume (RLV). However, mortality rates >12% have been reported. This study aimed to analyze the perioperative course of ALPPS and to identify factors associated with morbi-mortality. METHODS: Between April 2011 and September 2013, 62 patients operated in 9 Franco-Belgian hepatobiliary centres underwent ALPPS for colorectal metastases (N = 50) or primary tumors, following chemotherapy (N = 50) and/or portal vein embolization (PVE; N = 9)...
May 2015: European Journal of Surgical Oncology
Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh, Jae Berm Park, Mi Sook Gwak, Joon-Hyeok Lee, Gaab Soo Kim, Sung Joo Kim, Suk-Koo Lee
BACKGROUND/AIMS: The presence of bile duct tumor thrombi (BDTT) of hepatocellular carcinoma (HCC) in explant liver is considered to be a poor prognostic factor. However, studies about HCC BDTT in liver transplant recipients are rare. We compared the characteristics of liver transplant recipients with HCC BDTT in their pathology with those of recipients who had portal vein tumor thrombi (PVTT) of HCC in their pathology. METHODOLOGY: The medical records of patients who underwent liver transplantation from 2002 to 2008 at Samsung Medical Center were reviewed...
September 2014: Hepato-gastroenterology
S Rodrigues, A Martins, E Barroso
The decrease in the number of cadaveric donors has proved a limiting factor in the number of liver transplants, leading to the death of many patients on the waiting list. The living donor liver transplantation is an option that allows, in selected cases, increase the number of donors. One of the most serious complications in liver transplantation is hepatic artery thrombosis, in the past considered potentially fatal without urgent re-transplantation. A white male patient, 48 years old, diagnosed with hepatocellular carcinoma in chronic liver failure caused by hepatitis B virus, underwent living donor liver transplantation (right lobe)...
July 2014: Transplantation Proceedings
Atsushi Oba, Shinichiro Takahashi, Yuichiro Kato, Naoto Gotohda, Takahiro Kinoshita, Hidehito Shibasaki, Masafumi Ikeda, Masaru Konishi
BACKGROUND: The prognostic significance of bile duct tumor thrombus (BDTT) in hepatocellular carcinoma (HCC) is unclear and the usefulness of resection for HCC with BDTT is still controversial. The aim of the present study was to evaluate the impact of BDTT on prognosis in HCC and to determine whether resection of HCC with BDTT was useful. PATIENTS AND METHODS: Out of 820 HCC patients who underwent hepatic resection from 1992 to 2012, 13 HCC patients (1.6%) had macroscopic BDTT...
August 2014: Anticancer Research
K Sofue, Y Arai, K Shimada, Y Takeuchi, T Kobayashi, M Satake, K Sugimura
BACKGROUND: This study aimed to evaluate the safety and efficacy of preoperative right portal vein embolization (PVE) with absolute ethanol in patients with hepatobiliary malignancies. METHODS: PVE was performed via a percutaneous transhepatic ipsilateral approach, and the right portal branch was embolized with absolute ethanol. Technical success and complications following PVE, and changes in liver enzyme levels were evaluated. Changes in future liver remnant (FLR) and FLR/total functional liver volume ratio were calculated...
August 2014: British Journal of Surgery
K-S Jeng, C-C Huang, C-K Lin, C-C Lin, K-H Chen
BACKGROUND: Intrahepatic segmental portal vein thrombosis after living-related liver transplantation (LRLT) is uncommon. The cause remains unclear. METHODS: After providing written informed consent, 25 recipients receiving LRLT at our institution from January 2011 to September 2013 were enrolled in this study. We performed triphase computerized tomographic (CT) study of the liver graft of each recipient 1 month after LRLT. The patencies of hepatic artery, portal vein, and hepatic vein were evaluated in detail...
April 2014: Transplantation Proceedings
T-Y Ha, S Hwang, D-B Moon, C-S Ahn, K-H Kim, G-W Song, D-H Jung, G-C Park, H-W Park, Y-H Park, S-H Kang, B-H Jung, S-G Lee
BACKGROUND: Long-term prognosis of liver transplantation (LT) for hepatocellular carcinoma (HCC) with macroscopic bile duct tumor thrombus (BDTT) has not been well assessed. This study intended to analyze the post-transplantation outcomes in patients who had HCC with macroscopic BDTT. METHODS: A retrospective study was performed with 14 patients who underwent LT for HCC with BDTT (0.7%) after selection from an institutional database of 2052 adult LT cases. RESULTS: Types of LT were living donor LT in 13 and deceased donor LT in 1...
April 2014: Transplantation Proceedings
Shigeo Takahashi, Tomoki Kimura, Masahiro Kenjo, Ikuno Nishibuchi, Ippei Takahashi, Yuki Takeuchi, Yoshiko Doi, Yuko Kaneyasu, Yuji Murakami, Yoji Honda, Hiroshi Aikata, Kazuaki Chayama, Yasushi Nagata
The aim of this study was to evaluate portal vein and bile duct toxicity after stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC). We retrospectively reviewed 63 patients who were administrated SBRT once for HCC. The prescribed doses were from 48 Gy in four fractions to 60 Gy in eight fractions. Portal vein thrombosis and bile duct stenosis were evaluated. The dose received by 2% of the volume (D2 ) of the portal vein and bile duct was calculated. Portal vein thrombosis was observed in three patients (4...
October 2014: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Kyung Eun Lee, Chang Wook Kim, Min Ju Kim, Jinhee Park, Gu Min Cho, Jeong Won Jang, Young Sok Lee, Chang Don Lee
Massive bleeding hemobilia occurs rarely in patients with hepatocellular carcinoma (HCC) without any invasive procedure. Upper gastrointestinal bleeding in patient with cirrhosis and abdominal pain with progressive jaundice in patient with HCC were usually thought as variceal bleeding and HCC progression respectively. We experienced recently massive bleeding hemobilia in patient with HCC who was a 73-year old man and showed sudden abdominal pain, jaundice and hematochezia. He had alcoholic cirrhosis and history of variceal bleeding...
January 25, 2013: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Chao Liu, Jie Wang
OBJECTIVES: Hepatocellular carcinoma with bile duct tumor thrombus is considered an aggressive malignancy, and the prognosis of liver transplant for it remains obscure. MATERIALS AND METHODS: A 42-year-old man with recurrent hepatocellular carcinoma and a history of surgical resection was admitted to our hospital with a 10-day history of yellowish urine and itchy skin. There were 3 lesions in the right lobe with the diameter of 2 cm each. A mass was found in the upper part of common bile duct, and the intrahepatic bile duct was dilated...
December 2012: Experimental and Clinical Transplantation
Hiroshi Maruyama, Hiroshi Yoshida, Atsushi Hirakata, Takeshi Matsutani, Tadashi Yokoyama, Seiji Suzuki, Akira Matsushita, Koji Sasajima, Yuta Kikuchi, Eiji Uchida
We describe the surgical treatment of a patient with diaphragmatic invasion by a ruptured hepatocellular carcinoma (HCC) associated with biliary and portal venous tumor thrombi. A 67-year-old man was admitted because of jaundice (total serum bilirubin, 6.6 mg/dL). The serum concentration of alpha-fetoprotein was 236.1 ng/mL. The anti-hepatitis C virus antibodies were present in the serum. Computed tomography showed a large hypervascular mass in the right subphrenic region, surrounded by local effusion. Endoscopic retrograde cholangiography revealed dilatation of the left intrahepatic bile duct caused by biliary tumor thrombi extending from the right hepatic duct to the common bile duct...
2012: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Lizhong Jia, Shigeru Kiryu, Takeyuki Watadani, Hiroyuki Akai, Hideomi Yamashita, Masaaki Akahane, Kuni Ohtomo
Patients with hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombus (PVTT) have an extremely poor prognosis. It is important to select adequate therapeutic options based on reliable prognostic factors using imaging studies and clinical data. Prognostic factors were analyzed in patients with HCC with PVTT in the first branch or main trunk of the portal vein. From 2000 to 2007, 107 consecutive patients with HCC with PVTT in the major portal vein were reviewed, and diagnostic images and clinical characteristics were retrospectively observed...
2012: Acta Medica Okayama
Hugo Uchima-Koecklin, Domingo Balderramo, Andrés Cárdenas
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and the third cause of death related to cancer. Through the application of surveillance programs the percentage of early diagnosis has increased but the diagnosis is still made at advanced stages in some patients. The presentation of HCC as progressive jaundice secondary to bile duct tumor thrombi is uncommon. In such cases it is extremely difficult to distinguish such biliary lesions from cholangiocarcinoma or even common bile stones...
May 2012: Gastroenterología y Hepatología
Hiromichi Ishii, Takuma Kobayashi, Michihiro Kudou, Masumi Nishimura, Atsushi Toma, Kenji Nakamura, Takeshi Mazaki, Tsuyoshi Itoh
BACKGROUND: Hepatic resection is the only effective treatment for combined hepatocellular carcinoma and cholangiocarcinoma. CASE PRESENTATION: A 52-year-old man was preoperatively diagnosed with hepatocellular carcinoma in segment 2 with tumor thrombus in the segment 2 portal branch. Anatomical liver segmentectomy 2, including separation of the hepatic arteries, portal veins, and bile duct, enabled us to remove the tumor and portal thrombus completely. Modified selective hepatic vascular exclusion, which combines extrahepatic control of the left and middle hepatic veins with occlusion of left hemihepatic inflow, was used to reduce blood loss...
2012: World Journal of Surgical Oncology
Qing-Yu Liu, Dong-Ming Lai, Chao Liu, Lei Zhang, Wei-Dong Zhang, Hai-Gang Li, Ming Gao
AIM: To investigate the clinicopathologic features of bile duct tumor thrombus (BDTT) occurrence after treatment of primary small hepatocellular carcinoma (sHCC). METHODS: A total of 423 patients with primary sHCC admitted to our hospital underwent surgical resection or local ablation. During follow-up, only six patients were hospitalized due to obstructive jaundice, which occurred 5-76 mo after initial treatment. The clinicopathologic features of these six patients were reviewed...
November 21, 2011: World Journal of Gastroenterology: WJG
Boris Guiu, Frédéric Deschamps, Serge Aho, Flore Munck, Clarisse Dromain, Valérie Boige, David Malka, Sophie Leboulleux, Michel Ducreux, Martin Schlumberger, Eric Baudin, Thierry de Baere
BACKGROUND & AIMS: Transarterial chemoembolisation (TACE) is usually performed by injecting an emulsion of a drug and iodised oil. Drug-eluting beads (DEBs) have undeniable pharmacological advantages by offering simultaneous embolisation and sustained release of the drug to the tumour. No data are currently available on liver/biliary injury following DEB-TACE. This study describes and compares liver/biliary injuries encountered with TACE in tumours developed in cirrhotic (hepatocellular carcinoma (HCC)) and non-cirrhotic (endocrine tumours (NETs)) livers...
March 2012: Journal of Hepatology
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