[Surgical handling of primary hepatic carcinoma with severe cirrhosis and portal hypertension]

Abstract

Four hundred and ninety eight cases of primary hepatic carcinoma (PHC) were discovered complicating with cirrhosis in 608 PHC cases during 1974-1994. 63 cases of them were with severe cirrhosis and portal hypertension (10.4%). Laparotomy indication was evaluated according to Child's grade and image data such as BUS and CT etc. Operative extension should be limited as segment or wedge hepatectomy or semi-hepatic artery chemo-embolization. Splenic artery ligation plus venous ligalion of cardiac region of stomach were applied to portal hypertension and hypersplenism. Frusemide, antacid and insulin were used in the perioperation period. Three-year survival rate was 57%. It is considered that splenic artery ligation instead of splenectomy is the first choice for preventing and treating hypersplenism and digestive tract bleeding in PHC with severe cirrhosis.